Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation: A Community-Based Cohort Study

Cesare Russo; Zhezhen Jin; Fusako Sera; Edward S Lee; Shunichi Homma; Tatjana Rundek; Mitchell S V Elkind; Ralph L Sacco; Marco R Di Tullio

doi:10.1161/CIRCIMAGING.115.003520

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Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation: A Community-Based Cohort Study

Journal article

Open access

Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation: A Community-Based Cohort Study

Cesare Russo, Zhezhen Jin, Fusako Sera, Edward S Lee, Shunichi Homma, Tatjana Rundek, Mitchell S V Elkind, Ralph L Sacco and Marco R Di Tullio

Circulation. Cardiovascular imaging, Vol.8(8), pp.e003520-e003520

2015-08

DOI: https://doi.org/10.1161/CIRCIMAGING.115.003520

PMCID: PMC4531260

PMID: 26253626

Abstract

Myocardial Contraction

Ventricular Dysfunction, Left - epidemiology

Prospective Studies

Risk Assessment

Ventricular Function, Left

Humans

Middle Aged

Risk Factors

Echocardiography, Three-Dimensional

Stress, Mechanical

Male

Ventricular Dysfunction, Left - diagnosis

Atrial Fibrillation - physiopathology

Ventricular Dysfunction, Left - physiopathology

Incidence

Stroke Volume

Biomechanical Phenomena

Atrial Fibrillation - epidemiology

Time Factors

Aged, 80 and over

Female

New York City - epidemiology

Aged

Atrial Fibrillation - diagnosis

The increasing prevalence of atrial fibrillation (AF) represents a public health issue. Identifying new predictors of AF is therefore necessary to plan preventive strategies. We investigated whether left ventricular (LV) systolic dysfunction by global longitudinal strain (GLS), a predictor of cardiovascular events, may predict new-onset AF in a population setting. Participants (n=675; mean age, 71±9 years; 60% women) in sinus rhythm from the population-based Northern Manhattan Study (NOMAS) underwent 2- and 3-dimensional echocardiography as part of the Cardiac Abnormalities and Brain Lesions (CABL) study. LV systolic function was assessed by LV ejection fraction and speckle-tracking GLS. During a mean follow-up of 63.6±18.7 months, 32 (4.7%) new confirmed cases of AF occurred. Lower GLS (adjusted hazard ratio/unit decrease, 1.22; 95% confidence interval, 1.04-1.43; P=0.015) and increased left atrial volume index (LAVi; adjusted hazard ratio/unit increase, 1.12; 95% confidence interval, 1.07-1.17; P<0.001) were significantly associated with incident AF, whereas LV ejection fraction was not (P=0.176). Abnormal GLS (>-14.7%) was associated with risk of new-onset AF with an adjusted hazard ratio of 3.2 (95% confidence interval, 1.4-7.5; P=0.007). The coexistence of abnormal GLS/abnormal LAVi was associated with a 28.6% incidence of AF (adjusted hazard ratio, 12.1; 95% confidence interval, 3.3-44.8; P<0.001) compared with participants with normal GLS/normal LAVi (AF incidence, 2.0%). AF incidence was intermediate in those with either abnormal GLS or abnormal LAVi (9.3% and 11.1%, respectively). GLS prognostic value for incident AF was incremental over risk factors and LAVi. LV systolic dysfunction by GLS was a powerful and independent predictor of incident AF. GLS assessment may improve AF risk stratification in addition to established parameters.

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.37 Cardiology - General; 1.37.467 Echocardiography
Web Of Science research areas: Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging
ESI research areas: Clinical Medicine

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Title: Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation: A Community-Based Cohort Study
Creators: Cesare Russo - From the Division of Cardiology, Department of Medicine (C.R., F.S., E.S.L., S.H., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., R.L.S.), Department of Epidemiology and Public Health (T.R., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL. cr2321@cumc.columbia.edu
Zhezhen Jin - From the Division of Cardiology, Department of Medicine (C.R., F.S., E.S.L., S.H., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., R.L.S.), Department of Epidemiology and Public Health (T.R., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL
Fusako Sera - From the Division of Cardiology, Department of Medicine (C.R., F.S., E.S.L., S.H., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., R.L.S.), Department of Epidemiology and Public Health (T.R., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL
Edward S Lee - From the Division of Cardiology, Department of Medicine (C.R., F.S., E.S.L., S.H., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., R.L.S.), Department of Epidemiology and Public Health (T.R., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL
Shunichi Homma - From the Division of Cardiology, Department of Medicine (C.R., F.S., E.S.L., S.H., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., R.L.S.), Department of Epidemiology and Public Health (T.R., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL
Tatjana Rundek - From the Division of Cardiology, Department of Medicine (C.R., F.S., E.S.L., S.H., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., R.L.S.), Department of Epidemiology and Public Health (T.R., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL
Mitchell S V Elkind - From the Division of Cardiology, Department of Medicine (C.R., F.S., E.S.L., S.H., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., R.L.S.), Department of Epidemiology and Public Health (T.R., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL
Ralph L Sacco - From the Division of Cardiology, Department of Medicine (C.R., F.S., E.S.L., S.H., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., R.L.S.), Department of Epidemiology and Public Health (T.R., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL
Marco R Di Tullio - From the Division of Cardiology, Department of Medicine (C.R., F.S., E.S.L., S.H., M.R.D.T.), Department of Biostatistics (Z.J.), and Departments of Neurology and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Department of Neurology (T.R., R.L.S.), Department of Epidemiology and Public Health (T.R., R.L.S.), and Department of Human Genetics (R.L.S.), Miller School of Medicine, University of Miami, FL
Publication Details: Circulation. Cardiovascular imaging, Vol.8(8), pp.e003520-e003520
Publisher: United States
Grant note: R37 NS29993 / NINDS NIH HHS R01 NS036286 / NINDS NIH HHS R01 NS36286 / NINDS NIH HHS R37 NS029993 / NINDS NIH HHS R01 NS029993 / NINDS NIH HHS
Academic Unit: Leadership Department; Miller School of Medicine; UMMG Department of Neurology
Language: English
Resource Type: Journal article
PMID: 26253626
PMCID: PMC4531260
Record Identifier: 991031562281802976