AI Article Synopsis
- This study assessed echocardiographic features of left atrial (LA) structure and function in patients aged 75 and older with non-valvular atrial fibrillation (AF) to see how these features related to health outcomes over two years.
- It involved 1,474 elderly patients, analyzing aspects like LA emptying fraction (LAEF) and maximum LA volume index (max. LAVi), revealing that lower LAEF and higher max. LAVi were linked to higher risks of cardiovascular events, heart failure hospitalizations, and overall mortality.
- The findings suggest that elderly patients with poor LA function and larger LA volume need closer monitoring and management for better outcomes.
Article Abstract
Background: This prospective ANAFIE Registry substudy investigated the relationship between the echocardiographic parameters of left atrial (LA) structure and function and clinical outcomes at 2 years among atrial fibrillation (AF) patients aged ≥75 years.
Methods and results: Outcomes of 1,474 elderly non-valvular AF (NVAF) patients who underwent transthoracic echocardiography at baseline were analyzed by categories of maximum LA volume index (max. LAVi) and LA emptying fraction (LAEF) total. Baseline mean±standard deviation LAEF total and max. LAVi were 28.2±14.9% and 54.2±25.9 mL/m, respectively. Proportions of oral anticoagulant (OAC), direct OAC, and warfarin use were 92.7%, 68.7%, and 24.0%, respectively. Patients with LAEF total ≤45.0% (n=1,213) vs. >45.0% (n=224) were at higher risk of cardiovascular events (hazard ratio [HR]: 2.19, P=0.021) and heart failure (HF) hospitalization (HR: 2.25, P=0.045). Risk of all-cause death was higher with max. LAVi >48.0 mL/m(n=656) vs. ≤48.0 mL/m(n=621) (HR: 1.69, P=0.048). Subgroups with abnormal LA function and structure had increased incidence of cardiac/cardiovascular events and HF hospitalization. No significant interaction was observed between echocardiographic parameters and OAC type.
Conclusions: Elderly Japanese patients with NVAF and LAEF total ≤45.0% were at higher risk of cardiovascular events and HF hospitalization, and those with max. LAVi >48.0 mL/mwere at higher risk of all-cause death.
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| http://dx.doi.org/10.1253/circj.CJ-23-0084 | DOI Listing |
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