Department of Preventive Cardiology, National Cerebral and Cardiovascular Center.
Department of Preventive Medicine and Public Health, Keio University.
J Epidemiol. 2020 Apr 5;30(4):183-187. doi: 10.2188/jea.JE20180251. Epub 2019 Mar 30.
Left atrial dimension (LAD) and other parameters of echocardiography have been reported to be associated with the risk of atrial fibrillation (AF). However, few studies have investigated the associations between echocardiographic parameters and the risk of AF in the Asian general population, which has a low AF incidence.
A prospective cohort study was performed in 1,424 individuals in the Suita study with echocardiographic parameters, including LAD, and no history of AF. After echocardiography, the participants were followed using 12-lead electrocardiography and questionnaires to detect AF incidence. The multivariable-adjusted hazard ratios (HRs) of echocardiographic parameters for AF incidence were estimated after adjustment for the risk factors of the AF risk score.
During the median 6.0 years of follow-up, 31 AF cases occurred. The multivariable-adjusted HR of a 1-mm increase in LAD for AF was 1.18 (95% confidence interval [CI], 1.08-1.28). The multivariable-adjusted HR for AF of a 1-standard-deviation increase in LAD was higher than that of left ventricular internal dimensions in diastole, left ventricular mass, ejection fraction, and percent fractional shortening, and it was the only significant factor. In 667 participants with both LAD and LA volume (LAV) measurements, LAD and LAV were independently associated with the risk of AF incidence.
LAD on echocardiography was an independent risk factor of incident AF in the Japanese population. LAD might be useful for identifying individuals with a high risk of AF in health check-ups of the general population.
左心房内径（LAD）和超声心动图的其他参数已被报道与心房颤动（AF）的风险相关。然而，很少有研究调查亚洲普通人群中超声心动图参数与 AF 风险之间的关系，而亚洲普通人群的 AF 发病率较低。
在 Suita 研究中进行了一项前瞻性队列研究，纳入了 1424 名无 AF 病史的个体，进行了超声心动图参数检查，包括 LAD。在超声心动图检查后，通过 12 导联心电图和问卷调查对参与者进行随访，以检测 AF 发生率。在调整 AF 风险评分的危险因素后，估计超声心动图参数对 AF 发生率的多变量调整后的危险比（HR）。
在中位 6.0 年的随访期间，发生了 31 例 AF 病例。LAD 每增加 1mm，AF 的多变量调整 HR 为 1.18（95%置信区间[CI]，1.08-1.28）。LAD 每增加 1 个标准差，AF 的多变量调整 HR 高于舒张期左心室内径、左心室质量、射血分数和百分比较短，且是唯一显著的因素。在 667 名同时进行 LAD 和左心房容积（LAV）测量的参与者中，LAD 和 LAV 均与 AF 发生率的风险独立相关。
超声心动图上的 LAD 是日本人群中 AF 事件的独立危险因素。在普通人群的健康检查中，LAD 可能有助于识别 AF 风险较高的个体。
