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May 24, 2011Canadian Medical Association JournalOpen Access

Left atrial size and risk for all-cause mortality and ischemic stroke

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Why the study?

Does left atrial enlargement predict all-cause mortality and ischemic stroke in patients referred for echocardiography?

Population

52,639 adults who underwent a first clinically indicated transthoracic echocardiogram, mean age 61.8, 52.9%…

Comparison

Left atrial enlargement or increasing left… vs Normal left atrial size

Design

Cohort

Follow-up

mean 5.5 (SD 4.1) years

Authors

ABAlberto Bouzas‐MosqueraInstituto de Salud Carlos IIIFBF. J. BroullonComplexo Hospitalario Universitario A CoruñaEMEduardo MéndezUniversidad de la República de Uruguay

Discussion

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Implication

Should not yet guide decisions; hypothesis-generating for left atrial diameter in risk models.

Structured PICO

Does left atrial enlargement predict all-cause mortality and ischemic stroke in patients referred for echocardiography?

P
Population
52,639 adults (aged ≥18 years) who underwent a first clinically indicated transthoracic echocardiogram, mean age 61.8, 52.9% male.
I
Intervention
Left atrial enlargement (mild, moderate, or severe) or increasing left atrial diameter (per 1-cm increment)
C
Comparator
Normal left atrial size
O
Outcome
All-cause mortality and nonfatal ischemic strokehard clinical

Left atrial diameter, a simple and widely available echocardiographic parameter, has a graded and independent association with all-cause mortality in both sexes and with ischemic stroke in women.

Limitations

  • Observational study with potential residual confounding
  • Did not account for body mass index, antihypertensive medications, or Doppler estimators of left ventricular diastolic function
  • Left atrial diameter evaluated by either M-mode or two-dimensional echocardiography which may have discrepancies
  • Left atrial volume is a more reliable estimator than diameter but was not used

Cite This Study

Bouzas‐Mosquera et al. (2011) studied this question.

synapsesocial.com/papers/6a7e40e5299be60fdbb29924https://doi.org/10.1503/cmaj.091688

Topics

Echocardiography
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Left Atrial Size and the Risk of Stroke and Death1995 · 1,066 citations
  2. 2Left atrial remodelling in mitral regurgitation--methodologic approach, physiological determinants, and outcome implications: a prospective quantitative Doppler-echocardiographic and electron beam-computed tomographic study2007 · 172 citations
  3. 3Echocardiographic predictors of nonrheumatic atrial fibrillation. The Framingham Heart Study.1994 · 1,077 citations
  4. 4Incidence of and Risk Factors for Atrial Fibrillation in Older Adults1997 · 1,471 citations
  5. 5The Predictive Value of Left Atrial Size for Incident Ischemic Stroke and All-Cause Mortality in African Americans2008 · 71 citations