Dept. of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark; The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Dept. of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark; The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Int J Cardiol. 2024 Dec 15;417:132544. doi: 10.1016/j.ijcard.2024.132544. Epub 2024 Sep 12.
Left atrial (LA) strain by three-dimensional echocardiography (3DE), has been proposed as a more accurate measure of LA function, providing incremental prognostic benefits over traditional two-dimensional approaches.
Our aim was to evaluate the prognostic value of LA strain by 3DE in predicting incident atrial fibrillation (AF) in the general population.
The study included 4466 participants from a prospective longitudinal cohort study in the general population, among these 3DE LA strain was analysed in 1935 participants. The endpoint was incident AF. Adjustments were made for the CHARGE-AF clinical risk score.
Mean age was 54 ± 17 years, 43 % were male. During a median follow-up time of 4.8 years (interquartile range 4.3-5.5 years) 59 participants (3.0 %) developed AF. In univariable analysis, all three parameters were associated with incident AF (p value for all <0.01). After multivariable adjustments, only LA reservoir strain (LASr) and LA contractile strain (LASct) were associated with incident AF (LASr: HR 1.12 (1.07-1.17), p < 0.001, per 1 % decrease; LASct: HR 1.16 (1.09-1.24), p < 0.001, per 1 % decrease), whereas LA conduit strain (LAScd) was not (HR 1.04 (0.98-1.10), p = 0.17, per 1 % decrease). Both LASr (continuous net reclassification index 0.37 ± 0.14; p = 0.003) and LASct (continuous net reclassification index 0.41 ± 0.14; p = 0.002) provided incremental prognostic information beyond the CHARGE-AF risk score.
LASr and LASct measured by 3DE are independently associated with incident AF and provided incremental prognostic information beyond existing risk scores.
三维超声心动图（3DE）测量的左心房（LA）应变，已被提出作为更准确的 LA 功能测量方法，相较于传统二维方法提供了额外的预后益处。
我们旨在评估 3DE 测量的 LA 应变在预测普通人群中发生心房颤动（AF）方面的预后价值。
该研究纳入了一项前瞻性纵向队列研究中的 4466 名普通人群参与者，其中 1935 名参与者进行了 3DE LA 应变分析。终点为发生 AF。调整了 CHARGE-AF 临床风险评分。
平均年龄为 54±17 岁，43%为男性。中位随访时间为 4.8 年（四分位距 4.3-5.5 年），59 名参与者（3.0%）发生了 AF。在单变量分析中，所有三个参数均与发生 AF 相关（所有 p 值均<0.01）。多变量调整后，仅 LA 储备应变（LASr）和 LA 收缩应变（LASct）与发生 AF 相关（LASr：HR 1.12（1.07-1.17），p<0.001，每降低 1%；LASct：HR 1.16（1.09-1.24），p<0.001，每降低 1%），而 LA 传导应变（LAScd）则不然（HR 1.04（0.98-1.10），p=0.17，每降低 1%）。LASr（连续净重新分类指数 0.37±0.14；p=0.003）和 LASct（连续净重新分类指数 0.41±0.14；p=0.002）均提供了超越 CHARGE-AF 风险评分的额外预后信息。
3DE 测量的 LASr 和 LASct 与发生 AF 独立相关，并提供了超越现有风险评分的额外预后信息。
