Clinical and Echocardiographic Correlates of Left Atrial Function Index: The Framingham Offspring Study

Mayank Sardana, Gregory Nah, Connie W. Tsao, Adedotun A. Ogunsua, Eric Vittinghoff, Randell C. Thomas, Susan Cheng, Aditya Vaze, Jayashri R. Aragam, Gary F. Mitchell, Emelia J. Benjamin, Ramachandran S. Vasan, Gerard P. Aurigemma, Nelson B. Schiller, David D. McManus, Nisha I. Parikh

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background Left atrial (LA) remodeling is a predictor of cardiovascular disease (CVD). We performed measurement of the LA function index (LAFI), a composite measure of LA structure and function, in a community-based cohort and here report the distribution and cross-sectional correlates of LAFI. Methods In 1,719 Framingham Offspring Study participants (54% women, mean age 66 ± 9 years), we derived LAFI from the LA emptying fraction, left ventricular (LV) outflow tract velocity time integral, and indexed maximal LA volume. We used multivariable linear regression to assess the clinical and echocardiographic correlates of LAFI adjusting for age, sex, anthropometric measurements, and CVD risk factors. Results The average LAFI was 35.2 ± 12.1. Overall, LAFI declined with advancing age (β = −0.27, P <.001). LAFI was significantly higher (37.5 ± 11.6) in a subgroup of participants free of CVD and CVD risk factors compared with those with either of these conditions (34.5 ± 12.2). In multivariable models, LAFI was inversely related to antihypertensive use (β = −1.26, P =.038), prevalent atrial fibrillation (β = −4.46, P =.001), heart failure (β = −5.86, P =.008), and coronary artery disease (β = −2.01, P =.046). In models adjusting for echocardiographic variables, LAFI was directly related to LV ejection fraction (β = 14.84, P <.001) and inversely related to LV volume (β = −7.03, P <.001). Conclusions LAFI was inversely associated with antihypertensive use and prevalent CVD and was related to established echocardiographic traits of LV remodeling. Our results offer normative ranges for LAFI in a white community-based sample and suggest that LAFI represents a marker of pathological atrial remodeling.

Original languageEnglish (US)
Pages (from-to)904-912.e2
JournalJournal of the American Society of Echocardiography
Volume30
Issue number9
DOIs
StatePublished - Sep 2017
Externally publishedYes

Keywords

  • Atrial fibrillation
  • Cardiovascular diseases
  • Echocardiography
  • Epidemiology
  • Left atrial function
  • Left atrial function index

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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