Abstract 15557: Left Ventricular Mechanics as an Independent Risk Predictor of Atrial Fibrillation
Introduction: The incidence of atrial fibrillation (AF) in the community is increasing, and AF affects up to 20% of patients over the age of 80. Myocardial mechanics can be used to identify patients with subclinical left ventricular (LV) dysfunction, and may help to predict AF.
Aim: To investigate if LV mechanics is associated independently with risk of developing AF in patients with risk factors.
Methods: In a community-based study, participants’ ≥ 65 years were recruited if they had 1 or more risk factor (eg. Hypertension (HTN), diabetes mellitus (DM), obesity). Baseline echo and LV strain analysis was undertaken in all pts. Clinical AF risk was assessed using the CHARGE-AF score. Pts were split into four groups based on clinical AF risk (low 0-5%, medium 5-10%, high 10-15% and very high >15%). The association between LV strain and AF risk was compared using receiver operator characteristic (ROC) curves (to calculate area under the curve (AUC)) and multivariable linear regression.
Results: In 607 pts (age 71±5 yrs, male 47%), pts in the higher AF risk groups were older and had increased rates of HTN, DM and ischaemic heart disease (p<0.05). Higher AF risk was associated with lower mean ejection fraction (EF), global longitudinal strain (GLS), global circumferential strain (GCS) and higher mean E/e’ ratio, indexed left atrial (LA) volume and LV mass (p<0.01). Simple linear regression showed the same parameters except GCS were potential predictors of clinical AF risk (p<0.05). ROC curves showed that GLS>-18% (AUC 0.60 p<0.001), GCS>-22% (AUC 0.61 p=0.016), indexed LA volume >35 ml/m2 (AUC 0.586 p=0.001) and male gender (AUC 0.685 p<0.001) were all independent markers of clinical AF risk. Multivariable linear regression confirmed association of LV parameters with AF risk, independent of filling pressure (Table).
Conclusion: Myocardial mechanics are associated with AF risk, independent of loading conditions.
Author Disclosures: S. Ramkumar: None. H. Yang: None. Y. Wang: None. M. Nolan: None. K. Negishi: None. T.H. Marwick: None.
- © 2016 by American Heart Association, Inc.