Abstract 13194: Association Between Left Atrial Function and Frailty: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Background: Frailty is highly common in people with cardiovascular disease. Worse left atrial (LA) function is an independent risk factor for cardiovascular disease. However, whether worse LA function is independently associated with frailty is unclear. Aim: To evaluate the association of LA function with incident frailty in community-dwelling older adults. Methods: We included 3,292 older adults from the Atherosclerosis Risk in Communities (ARIC) study who were non-frail at baseline (visit 5, 2011-2013) and had LA function (reservoir strain, conduit strain, and contractile strain) measured from two-dimensional speckle-tracking echocardiography. The validated Fried frailty phenotype, which includes measurements of weight loss, slowness, exhaustion, weakness, and low physical activity, was used to define frailty (≥3 of the 5 components). Incident frailty was assessed between 2016 and 2019 during 2 follow-up visits; all the included participants attended at least 1 of the 2 visits. LA function was assessed continuously (per 1-SD decrement) and categorically in quintiles. Multivariable logistic regression was used for analysis. Results: The median (IQR) age was 74 (71-77) years (58% female) and 214 (7%) participants developed frailty during a median (IQR) follow-up of 6.3 (5.6-6.8) years. After adjusting for potential confounders, each 1-SD decrement in LA reservoir strain and LA contractile strain was associated with 35% (95% CI: 11-65%) and 22% (95% CI: 2-45%), respectively, greater odds of developing frailty ( Table 1 ). Compared to the highest quintile, participants in the lowest quintile of LA reservoir strain had 2.3-fold greater odds of developing frailty. Conclusions: Worse LA function is associated with higher incidence of frailty. Future studies are needed to investigate the mechanism underlying this association.