Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up

被引:183
作者
Osranek, M
Bursi, F
Bailey, KR
Grossardt, BR
Brown, RD
Kopecky, SL
Tsang, TS
Seward, JB
机构
[1] Mayo Clin & Mayo Fdn, Div Cardiovasc Dis, Rochester, MN 55905 USA
[2] Mayo Clin, Div Biostat, Rochester, MN USA
[3] Mayo Clin, Dept Neurol, Rochester, MN USA
关键词
lone atrial fibrillation; left atrial volume; echocardiography; cerebral infarction;
D O I
10.1093/eurheartj/ehi483
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims The objectives of this study were to determine the long-term outcome and the predictors of adverse events in patients originally diagnosed with lone atrial fibrillation (AF). Methods and results This population-based historical cohort study comprised 46 residents of Olmsted County, MN, USA, with well-documented, clinically defined lone AF and a complete two-dimensional echocardiographic examination. The original echocardiographic videotape recordings were analysed in a blinded fashion for left atrial volume (LAV) and left ventricular ejection fraction. With 1296 person-years of follow-up, the median duration of AF was 27 (first quartile=24, third quartile=33) years. Twenty-three (50%) patients developed events. Cerebral infarction occurred in seven patients, myocardial infarction in 11, and congestive heart failure in 16. In a multivariable analysis, patients with indexed LAV >= 32 mL/m(2) had a significantly worse event-free survival (adjusted HR, 4.46; 95% CI, 1.56-12.74; P=0.005). All cerebral infarctions occurred in patients with an indexed LAV > 32 mL/m(2). Conclusion Patients originally diagnosed with benign lone AF follow divergent courses based on LAV. Those originally diagnosed with lone AF and normal sized atria had a benign clinical course throughout the long-term follow-up. Patients with increased LAV at diagnosis or later during the follow-up experienced adverse events.
引用
收藏
页码:2556 / 2561
页数:6
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