Abstract 13523: Association of Central Arterial Stiffness With Atrial Myopathy: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Introduction: Atrial myopathy—defined as abnormal left atrial (LA) size and function— is associated with an increased risk of atrial fibrillation, heart failure, and dementia. Defining risk factors for atrial myopathy is important for identifying preventative therapies. Objective: Examine the cross-sectional association of central arterial stiffness with LA function. Methods: We included 2,825 Atherosclerosis Risk in Communities (ARIC) study participants from Visit 5 (2011-2013) without coronary heart disease, heart failure, sustained arrhythmias, peripheral arterial disease, or morbid obesity (mean age=75 years, 65% female, 20% Black). Central arterial stiffness was measured by carotid-femoral pulse wave velocity (cfPWV). cfPWV was analyzed continuously per standard deviation (SD) increment and categorically by quartiles. LA strain (function) was measured by speckle-tracking echocardiography. Multivariable linear regression was performed. Results: When analyzed per SD increment, cfPWV was significantly associated with LA reservoir and conduit strain, after adjusting for demographics, clinical characteristics, systolic blood pressure, and left ventricular (LV) function and mass (β=-0.33, 95% CI [-0.60, -0.06] and β=-0.31, 95% CI [-0.52, -0.10], respectively) (Table). When cfPWV was assessed as quartiles, compared to the referent 1 st quartile (lowest), participants in the 4 th quartile (highest) of cfPWV had significantly lower LA reservoir and conduit strain (β=-0.83, 95% [-1.58, -0.08] and β=-0.96, 95% CI [-1.54, -0.38], respectively). There was no significant association between cfPWV and LA contractile strain. Conclusion: Higher central arterial stiffness is cross-sectionally associated with lower LA reservoir and conduit (but not contractile) strain, independent of LV function and mass. Future research examining the prospective association of central arterial stiffness with change in LA function is warranted.