Association of right atrial structure with incident atrial fibrillation: a longitudinal cohort cardiovascular magnetic resonance study from the Multi-Ethnic Study of Atherosclerosis (MESA)
Abstract Background While studies of the left atrium (LA) have demonstrated associations between volumes and emptying fraction with atrial fibrillation (AF), the contribution of right atrial (RA) abnormalities to incident AF remains poorly understood. Objectives Assess the association between RA str...
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doaj-4f443013a2ac49a18f44ed329cfce7912020-11-25T03:48:44ZengBMCJournal of Cardiovascular Magnetic Resonance1532-429X2020-05-0122111010.1186/s12968-020-00631-1Association of right atrial structure with incident atrial fibrillation: a longitudinal cohort cardiovascular magnetic resonance study from the Multi-Ethnic Study of Atherosclerosis (MESA)Eric Xie0Ricky Yu1Bharath Ambale-Venkatesh2Hooman Bakhshi3Susan R. Heckbert4Elsayed Z. Soliman5David A. Bluemke6Steven M. Kawut7Colin O. Wu8Saman Nazarian9João A. C. Lima10Cardiology Division, Department of Medicine, Johns Hopkins HospitalHeart Service, Department of Medicine, UCLA School of MedicineDepartment of Radiology, Johns Hopkins HospitalCardiology Division, Department of Medicine, Johns Hopkins HospitalDepartment of Epidemiology, School of Public Health, University of WashingtonDepartment of Epidemiology and Prevention, Epidemiological Cardiology Research Center, Wake Forest School of MedicineRadiology and Imaging Sciences, National Institutes of HealthDepartment of Medicine, Perelman School of Medicine at the University of PennsylvaniaOffice of Biostatistics Research, National Heart, Lung and Blood Institute, National Institutes of HealthCardiology Division, Department of Medicine, Johns Hopkins HospitalCardiology Division, Department of Medicine, Johns Hopkins HospitalAbstract Background While studies of the left atrium (LA) have demonstrated associations between volumes and emptying fraction with atrial fibrillation (AF), the contribution of right atrial (RA) abnormalities to incident AF remains poorly understood. Objectives Assess the association between RA structure and function with incident AF using feature-tracking cardiovascular magnetic resonance (CMR). Methods This is a prospective cohort study of all participants in the Multi-Ethnic Study of Atherosclerosis with baseline CMR, sinus rhythm, and free of clinical cardiovascular disease at study initiation. RA volume, strain, and emptying fraction in participants with incident AF (n = 368) were compared against AF-free (n = 2779). Cox proportional-hazards models assessed association between variables. Results Participants were aged 60 ± 10 yrs., 55% female, and followed an average 11.2 years. Individuals developing AF had higher baseline RA maximum volume index (mean ± standard deviation [SD]: 24 ± 9 vs 22 ± 8 mL/m2, p = 0.002) and minimum volume index (13 ± 7 vs 12 ± 6 mL/m2, p < 0.001), and lower baseline RA emptying fraction (45 ± 15% vs 47 ± 15%, p = 0.02), peak global strain (34 ± 17% vs 36 ± 19%, p < 0.001), and peak free-wall strain (40 ± 23% vs 42 ± 26%, p = 0.049) compared with the AF-free population. After adjusting for traditional cardiovascular risk factors and LA volume and function, we found RA maximum volume index (hazards ratio [HR]: 1.13 per SD, p = 0.041) and minimum volume index (HR: 1.12 per SD, p = 0.037) were independently associated with incident AF. Conclusions In a large multiethnic population, higher RA volume indices were independently associated with incident AF after adjustment for conventional cardiovascular risk factors and LA parameters. It is unclear if this predictive value persists when additional adjustment is made for ventricular parameters.http://link.springer.com/article/10.1186/s12968-020-00631-1Cardiovascular magnetic resonanceFeature trackingAtrial volumeStrainAtrial fibrillation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Eric Xie Ricky Yu Bharath Ambale-Venkatesh Hooman Bakhshi Susan R. Heckbert Elsayed Z. Soliman David A. Bluemke Steven M. Kawut Colin O. Wu Saman Nazarian João A. C. Lima |
spellingShingle |
Eric Xie Ricky Yu Bharath Ambale-Venkatesh Hooman Bakhshi Susan R. Heckbert Elsayed Z. Soliman David A. Bluemke Steven M. Kawut Colin O. Wu Saman Nazarian João A. C. Lima Association of right atrial structure with incident atrial fibrillation: a longitudinal cohort cardiovascular magnetic resonance study from the Multi-Ethnic Study of Atherosclerosis (MESA) Journal of Cardiovascular Magnetic Resonance Cardiovascular magnetic resonance Feature tracking Atrial volume Strain Atrial fibrillation |
author_facet |
Eric Xie Ricky Yu Bharath Ambale-Venkatesh Hooman Bakhshi Susan R. Heckbert Elsayed Z. Soliman David A. Bluemke Steven M. Kawut Colin O. Wu Saman Nazarian João A. C. Lima |
author_sort |
Eric Xie |
title |
Association of right atrial structure with incident atrial fibrillation: a longitudinal cohort cardiovascular magnetic resonance study from the Multi-Ethnic Study of Atherosclerosis (MESA) |
title_short |
Association of right atrial structure with incident atrial fibrillation: a longitudinal cohort cardiovascular magnetic resonance study from the Multi-Ethnic Study of Atherosclerosis (MESA) |
title_full |
Association of right atrial structure with incident atrial fibrillation: a longitudinal cohort cardiovascular magnetic resonance study from the Multi-Ethnic Study of Atherosclerosis (MESA) |
title_fullStr |
Association of right atrial structure with incident atrial fibrillation: a longitudinal cohort cardiovascular magnetic resonance study from the Multi-Ethnic Study of Atherosclerosis (MESA) |
title_full_unstemmed |
Association of right atrial structure with incident atrial fibrillation: a longitudinal cohort cardiovascular magnetic resonance study from the Multi-Ethnic Study of Atherosclerosis (MESA) |
title_sort |
association of right atrial structure with incident atrial fibrillation: a longitudinal cohort cardiovascular magnetic resonance study from the multi-ethnic study of atherosclerosis (mesa) |
publisher |
BMC |
series |
Journal of Cardiovascular Magnetic Resonance |
issn |
1532-429X |
publishDate |
2020-05-01 |
description |
Abstract Background While studies of the left atrium (LA) have demonstrated associations between volumes and emptying fraction with atrial fibrillation (AF), the contribution of right atrial (RA) abnormalities to incident AF remains poorly understood. Objectives Assess the association between RA structure and function with incident AF using feature-tracking cardiovascular magnetic resonance (CMR). Methods This is a prospective cohort study of all participants in the Multi-Ethnic Study of Atherosclerosis with baseline CMR, sinus rhythm, and free of clinical cardiovascular disease at study initiation. RA volume, strain, and emptying fraction in participants with incident AF (n = 368) were compared against AF-free (n = 2779). Cox proportional-hazards models assessed association between variables. Results Participants were aged 60 ± 10 yrs., 55% female, and followed an average 11.2 years. Individuals developing AF had higher baseline RA maximum volume index (mean ± standard deviation [SD]: 24 ± 9 vs 22 ± 8 mL/m2, p = 0.002) and minimum volume index (13 ± 7 vs 12 ± 6 mL/m2, p < 0.001), and lower baseline RA emptying fraction (45 ± 15% vs 47 ± 15%, p = 0.02), peak global strain (34 ± 17% vs 36 ± 19%, p < 0.001), and peak free-wall strain (40 ± 23% vs 42 ± 26%, p = 0.049) compared with the AF-free population. After adjusting for traditional cardiovascular risk factors and LA volume and function, we found RA maximum volume index (hazards ratio [HR]: 1.13 per SD, p = 0.041) and minimum volume index (HR: 1.12 per SD, p = 0.037) were independently associated with incident AF. Conclusions In a large multiethnic population, higher RA volume indices were independently associated with incident AF after adjustment for conventional cardiovascular risk factors and LA parameters. It is unclear if this predictive value persists when additional adjustment is made for ventricular parameters. |
topic |
Cardiovascular magnetic resonance Feature tracking Atrial volume Strain Atrial fibrillation |
url |
http://link.springer.com/article/10.1186/s12968-020-00631-1 |
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