Left Atrial Volumes and Function, and Long-Term Incidence of Ischemic Stroke in the General Population
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Left Atrial Volumes and Function, and Long-Term Incidence of Ischemic Stroke in the General Population. / Larsen, Bjørn Strøier; Olsen, Flemming Javier; Andersen, Ditte Madsen; Madsen, Christoffer Valdorff; Møgelvang, Rasmus; Jensen, Gorm Boje; Schnohr, Peter; Aplin, Mark; Høst, Nis Baun; Christensen, Hanne; Sajadieh, Ahmad; Biering-Sørensen, Tor.
In: Journal of the American Heart Association, Vol. 11, No. 18, e027031, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Left Atrial Volumes and Function, and Long-Term Incidence of Ischemic Stroke in the General Population
AU - Larsen, Bjørn Strøier
AU - Olsen, Flemming Javier
AU - Andersen, Ditte Madsen
AU - Madsen, Christoffer Valdorff
AU - Møgelvang, Rasmus
AU - Jensen, Gorm Boje
AU - Schnohr, Peter
AU - Aplin, Mark
AU - Høst, Nis Baun
AU - Christensen, Hanne
AU - Sajadieh, Ahmad
AU - Biering-Sørensen, Tor
N1 - Funding Information: BSL was financed by the Lundbeck Foundation (Grant no. R286-2018-1420) and Bispebjerg & Frederiksberg Research foundation. The Danish Heart Foundation funded the Copenhagen City Heart Study, and the Lundbeck Foundation further funded the echocardiographic substudy. Funding Information: Sources of Funding BSL was financed by the Lundbeck Foundation (Grant no. R286-2018-1420) and Bispebjerg & Frederiksberg Research foundation. The Danish Heart Foundation funded the Copenhagen City Heart Study, and the Lundbeck Foundation further funded the echocardiographic substudy.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: Left atrial (LA) volumes and emptying fraction in the general population may address structural and functional aspects of atrial cardiomyopathy associated with long-term risk of ischemic stroke in the absence of atrial fibrillation or prior stroke. We investigated the association between LA volumes and function and ischemic stroke. METHODS AND RESULTS: In a community-based cohort, we measured LA minimal volume, LA maximal volume, and LA emptying fraction by transthoracic echocardiography. The primary end point was ischemic stroke. Participants with known atrial fibrillation or prior ischemic stroke were excluded, which resulted in 1866 participants. The mean age was 58±16 years, and 57% were women. During a median follow-up of 16.5 years (interquartile range: 11.4–16.8 years), 176 (9.4%) ischemic strokes occurred. In multivariable cause-specific regression models and competing risk models with death as a competing risk, LA emptying fraction was associated with ischemic stroke (hazard ratio [HR], 1.14 per 10% decrease [95% CI, 1.02–1.28]) and (subdistribution HR, 1.14 [95% CI, 1.01–1.29]). This association remained when adjusting for participants who developed atrial fibrillation during follow-up (HR, 1.12 per 10% decrease [95% CI, 1.00–1.26]). Indexed LA volumes were not associated with ischemic stroke in the same models. LA emptying fraction and indexed LA volumes were not associated with all-cause mortality. CONCLUSIONS: Lower LA emptying fraction measured by transthoracic echocardiography was associated with future ischemic stroke independently of incident atrial fibrillation. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02993172.
AB - BACKGROUND: Left atrial (LA) volumes and emptying fraction in the general population may address structural and functional aspects of atrial cardiomyopathy associated with long-term risk of ischemic stroke in the absence of atrial fibrillation or prior stroke. We investigated the association between LA volumes and function and ischemic stroke. METHODS AND RESULTS: In a community-based cohort, we measured LA minimal volume, LA maximal volume, and LA emptying fraction by transthoracic echocardiography. The primary end point was ischemic stroke. Participants with known atrial fibrillation or prior ischemic stroke were excluded, which resulted in 1866 participants. The mean age was 58±16 years, and 57% were women. During a median follow-up of 16.5 years (interquartile range: 11.4–16.8 years), 176 (9.4%) ischemic strokes occurred. In multivariable cause-specific regression models and competing risk models with death as a competing risk, LA emptying fraction was associated with ischemic stroke (hazard ratio [HR], 1.14 per 10% decrease [95% CI, 1.02–1.28]) and (subdistribution HR, 1.14 [95% CI, 1.01–1.29]). This association remained when adjusting for participants who developed atrial fibrillation during follow-up (HR, 1.12 per 10% decrease [95% CI, 1.00–1.26]). Indexed LA volumes were not associated with ischemic stroke in the same models. LA emptying fraction and indexed LA volumes were not associated with all-cause mortality. CONCLUSIONS: Lower LA emptying fraction measured by transthoracic echocardiography was associated with future ischemic stroke independently of incident atrial fibrillation. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02993172.
KW - echocardiography
KW - epidemiology
KW - ischemic stroke
KW - left atrium
U2 - 10.1161/JAHA.122.027031
DO - 10.1161/JAHA.122.027031
M3 - Journal article
C2 - 36073645
AN - SCOPUS:85138398507
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 18
M1 - e027031
ER -
ID: 325442681