Greater Central Adiposity Is Associated With Poorer Left Atrial Function: The Atherosclerosis Risk in Communities (ARIC) Study

Figures

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  Figure 1. This flow chart illustrates the participant selection process for a study using the Atherosclerosis Risk in Communities (ARIC) Study data from visit 5 (2011-2013). From an initial population of 6538 participants who attended visit 5, 6118 underwent echocardiogram assessment. After applying 9 exclusion criteria that removed 2110 participants owing to missing data (LA function measures, BMI, WC/WHR, echocardiographic data, covariates), clinical conditions (prevalent AF or HF), and demographic factors (specific Black participants and non-Black/White participants), the final analytical sample consisted of 4008 participants. AF, atrial fibrillation; BMI, body mass index; HF, heart failure; LA, left atrial; WC, waist circumference; WHR, waist-to-hip ratio; V, visit.

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  Figure 2. Predicted mean values of measures of LA function presented as solid line with its 95% CI as the shaded region. Estimates adjusted for age, sex, and race, calculated by restricted cubic spline regression with 5 knots placed at 5th, 27.5th, 50th, 72.5th, and 95th percentile values of the respective exposure variables. For example, the curve associations between WC (A), WHR (D), and BMI (G) with LA reservoir strain display an inverse relationship. Furthermore, the associations between WC (C), WHR (F), and BMI (I) with LA contractile strain follow an inverted U-shaped and multiphasic trend. BMI, body mass index; LA, left atrial; WC, waist circumference; WHR, waist-to-hip ratio.