Abstract
Left atrium (LA) size is associated with adverse cardiovascular events. The purpose of this study was to investigate the association of LA enlargement measured by non-contrast CT (NCCT) with traditional cardiovascular risk factors. Individuals aged 60–75 years from the population-based multicentre Danish Cardiovascular Screening (DANCAVAS) trial were included in this cross-sectional study. The LA was manually traced on the NCCT scans, and the largest cross-section area was indexed to body surface area. All traditional risk factors were recorded, and a subgroup received an echocardiographic examination. We enrolled 14,987 individuals. Participants with known cardiovascular disease or lacking measurements of LA size or body surface area were excluded, resulting in 10,902 men for the main analysis and 616 women for a sensitivity analysis. Adjusted multivariable analysis showed a significantly increased indexed LA size by increasing age and pulse pressure, while smoking, HbA1c, and total cholesterol were associated with decreased indexed LA size. The findings were confirmed in a supplementary analysis including left ventricle ejection fraction and mass. In this population-based cohort of elderly men, an association was found between age and pulse pressure and increasing LA size. Surprisingly, smoking, HbA1c, and total cholesterol were associated with a decrease in LA size. This indicates that the pathophysiology behind atrial cardiomyopathy is not only reflected by enlargement, but also shrinking.
Highlights
Left atrial (LA) size is associated with adverse cardiovascular events and has been recognised to be an independent predictor of cardiovascular outcome [1,2,3,4]
14,987 individuals participated in the screening trials
We examined individuals without know smoking cardiovascular disease, smoking is associated with AF and an indisputable relationship exists between Left atrium (LA) size and AF, our findings seem paradoxical
Summary
Left atrial (LA) size is associated with adverse cardiovascular events and has been recognised to be an independent predictor of cardiovascular outcome [1,2,3,4]. LA size is connected to the risk of atrial fibrillation and heart failure, the risk factors causing. LA dilation would be expected to be similar to those leading to atrial fibrillation and heart failure. Hypertension and obesity are some of the most important modifiable risk factors for atrial fibrillation; in addition, diabetes, obstructive sleep apnoea, smoking and alcohol use are known to increase the risk of atrial fibrillation [5]. Examining associations between LA size and risk factors could improve our understanding of mechanisms behind atrial cardiomyopathy. An increasing number of patients are examined by cardiac non-contrast computed tomography (NCCT) to evaluate coronary artery calcium (CAC) score, as this is the most important risk marker of cardiovascular disease [6,7].
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