Determinants of Left Atrial Volume in Patients with Atrial Fibrillation

Bossard, M. and Kreuzmann, R. and Hochgruber, T. and Krisai, P. and Zimmermann, A. J. and Aeschbacher, S. and Pumpol, K. and Kessel-Schaefer, A. and Stephan, F. P. and Handschin, N. and Sticherling, C. and Osswald, S. and Kaufmann, B. A. and Pare, G. and Kuhne, M. and Conen, D.. (2016) Determinants of Left Atrial Volume in Patients with Atrial Fibrillation. PLoS One, 11 (10). e0164145.

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Official URL: https://edoc.unibas.ch/62154/

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INTRODUCTION: Left atrial (LA) enlargement is an important risk factor for incident stroke and a key determinant for the success of rhythm control strategies in patients with atrial fibrillation (AF). However, factors associated with LA volume in AF patients remain poorly understood. METHODS: Patients with paroxysmal or persistent AF were enrolled in this study. Real time 3-D echocardiography was performed in all participants and analyzed offline in a standardized manner. We performed stepwise backward linear regression analyses using a broad set of clinical parameters to determine independent correlates for 3-D LA volume. RESULTS: We included 210 patients (70.9% male, mean age 61+/-11years). Paroxysmal and persistent AF were present in 95 (45%) and 115 (55%) patients, respectively. Overall, 115 (55%) had hypertension, 11 (5%) had diabetes, and 18 (9%) had ischemic heart disease. Mean indexed LA volume was 36+/-12ml/m2. In multivariable models, significant associations were found for female sex (beta coefficient -10.51 (95% confidence interval (CI) -17.85;-3.16), p = 0.0053), undergoing cardioversion (beta 11.95 (CI 5.15; 18.74), p = 0.0006), diabetes (beta 14.23 (CI 2.36; 26.10), p = 0.019), body surface area (BSA) (beta 34.21 (CI 19.30; 49.12), p>0.0001), glomerular filtration rate (beta -0.21 (CI -0.36; -0.06), p = 0.0064) and plasma levels of NT-pro brain natriuretic peptide (NT-proBNP) (beta 6.79 (CI 4.05; 9.52), p>0.0001), but not age (p = 0.59) or hypertension (p = 0.42). Our final model explained 52% of the LA volume variability. CONCLUSIONS: In patients with AF, the most important correlates with LA volume are sex, BSA, diabetes, renal function and NT-proBNP, but not age or hypertension. These results may help to refine rhythm control strategies in AF patients.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Department of Biomedicine, University Hospital Basel > Cardiovascular Molecular Imaging (Kaufmann)
UniBasel Contributors:Kaufmann, Beat
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1932-6203 (Electronic) 1932-6203 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:31 May 2020 17:21
Deposited On:31 May 2020 17:21

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