Arrhythmias & electrophysiologyResearch article

Right and Left Atrial Dysfunction as Independent Cardiovascular Risk Factors: A UK Biobank Study

Circ Arrhythm ElectrophysiolPublished

  • UK Biobank Study
  • cardiac magnetic resonance imaging using deep learning segmentation
  • genome-wide association study
  • Mendelian randomization

Authors' conclusion

In this largest assessment of biatrial structure and function to date, both left and right atrial cardiopathies were independently associated with increased risk of adverse cardiovascular events. We identified several novel genetic loci for atrial traits and observed unique genetic correlations between left and right atrial traits and cardiovascular phenotypes, providing insight into chamber-specific remodeling. Several of these measures are likely to be causal determinants of cardiovascular complications previously attributed to AF.

Study context

Population
UK Biobank participants without prevalent atrial fibrillation (AF)UK Biobank participants without prevalent AF
Participants
51,693 participants
Comparison
Associations of biatrial volumes and emptying fraction with new-onset AF, ischemic stroke, heart failure, and dementia

Main finding

As reported in the abstract

Incident events:
  • AF
  • Ischemic stroke
  • Heart failure
  • Dementia
· 4-year follow-up

developed AF

964 (1.9%)

developed ischemic stroke

266 (0.5%)

developed heart failure

365 (0.7%)

developed dementia

72 (0.1%)

Further findings

New-onset AF by left atrial minimal volume

Comparisonhazard ratio (95% CI)
left atrial minimal volume · after adjustment for clinical risk factors1.55 (1.48–1.62)

New-onset AF by left atrial minimal volume

Both left and right atrial measures associated with new-onset AF, ischemic stroke, and heart failure, with stronger associations in women
Left atrial minimal volume also associated with dementia

Genome-wide association study

genetic associations with atrial measures
51 (27 novel)
Each atrium had varying correlations with cardiometabolic risk factors

Mendelian randomization

Left atrial measures had direct causal effects on AF and stroke risk
Stroke associations attenuated after accounting for AF variants

Original publication

Right and Left Atrial Dysfunction as Independent Cardiovascular Risk Factors: A UK Biobank Study. Circ Arrhythm Electrophysiol. Published 26 February 2026. doi:10.1161/circep.125.014412

Summarised from the published abstract; every number is checked against it