Abstract 13569: Left Atrial Function and Incident Heart Failure: Results from The Multi-Ethnic Study of Atherosclerosis(MESA)
Background: Limited information is available in using MRI for left atrial (LA) volume and strain assessment in a prospective multi-ethnic study. We hypothesized that worsening of atrial function, assessed by MRI, is associated with higher incident of heart failure (HF).
Methods: In a case-control study nested in the Multi-Ethnic Study of Atherosclerosis (MESA), we used tissue tracking of MRI images to assess baseline atrial function of participants. All individuals were in normal sinus rhythm, without any significant valvular or clinical cardiovascular diseases. Participants were prospectively followed for a mean of 6.9 years. MRI images of 87 individuals with HF during the follow-up (mean age 68.8±8.9 years, 66% men) were compared to the images of 170 age and sex matched controls (mean age 68.1 ± 8.1 years, 66% men).
Results: Individuals with HF had higher maximum and minimum LA volume index (LAVI) than controls at baseline (40 ±13mm3/m2 vs. 33 ± 10 mm3/m2, p<0.0001; 24 ± 12mm3/m2 vs. 17 ± 7 mm3/m2, p<0.0001, respectively). They also had lower peak global longitudinal atrial strain (25 ± 13% vs. 38 ± 17%, p<0.0001) and LA ejection fraction (LAEF) (39 ± 11% vs. 48 ± 11%, p<0.0001). After adjustment for traditional HF risk factors and left ventricular mass, there was a significant association between minimum LAVI and maximum LAVI with subsequent HF (odds ratio (OR) for maximum LAVI=1.58 per SD, CI 1.09-2.29 and OR for minimum LAVI=2.12 per SD, CI 1.39-3.22). Similar findings were observed for peak global longitudinal atrial strain (OR 0.47 per SD, CI 0.30-0.73) and LAEF (OR 0.49 per SD, CI 0.33-0.72). After additionally adjusting for NT-pro BNP, the association persisted only for peak global longitudinal atrial strain (OR 0.54 per SD, CI 0.32-0.89).
Conclusion: Lower peak global longitudinal atrial strain was independently associated with incident HF. This finding suggests that LA strain measured by MRI may serve as an independent predictor of HF in asymptomatic adults.
- © 2012 by American Heart Association, Inc.