Key result
Higher baseline right atrial maximum volume index was independently associated with an increased risk of incident atrial fibrillation (HR 1.13 per SD) after adjusting for clinical risk factors.
Why the study?
While left atrial abnormalities are known to be associated with atrial fibrillation, the contribution of right atrial abnormalities to incident atrial fibrillation remains poorly understood.
Are right atrial structure and function abnormalities associated with incident atrial fibrillation in a population free of clinical cardiovascular disease?
Cohort (n=3,147)
Yes
Are right atrial structure and function abnormalities associated with incident atrial fibrillation in a population free of clinical cardiovascular disease?
Higher right atrial volume indices assessed by CMR are independently associated with incident atrial fibrillation, extending predictive value beyond traditional risk factors and left atrial parameters.
BACKGROUND: While studies of the left atrium (LA) have demonstrated associations between volumes and emptying fraction with atrial fibrillation (AF), the contribution of right atrial (RA) abnormalities to incident AF remains poorly understood. OBJECTIVES: Assess the association between RA structure and function with incident AF using feature-tracking cardiovascular magnetic resonance (CMR). METHODS: This is a prospective cohort study of all participants in the Multi-Ethnic Study of Atherosclerosis with baseline CMR, sinus rhythm, and free of clinical cardiovascular disease at study initiation. RA volume, strain, and emptying fraction in participants with incident AF (n = 368) were compared against AF-free (n = 2779). Cox proportional-hazards models assessed association between variables. After adjusting for traditional cardiovascular risk factors and LA volume and function, we found RA maximum volume index (hazards ratio [HR]: 1.13 per SD, p = 0.041) and minimum volume index (HR: 1.12 per SD, p = 0.037) were independently associated with incident AF. CONCLUSIONS: In a large multiethnic population, higher RA volume indices were independently associated with incident AF after adjustment for conventional cardiovascular risk factors and LA parameters. It is unclear if this predictive value persists when additional adjustment is made for ventricular parameters.
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Xie et al. (2020) conducted a cohort in Incident atrial fibrillation (n=3,147). Right atrial maximum volume index was evaluated on Incident atrial fibrillation (HR 1.13, 95% CI 1.00-1.27, p=0.041). Higher baseline right atrial maximum volume index was independently associated with an increased risk of incident atrial fibrillation (HR 1.13 per SD) after adjusting for clinical risk factors.
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