Clinical impact of left atrial enlargement in Korean patients with atrial fibrillation

Min Soo Cho, Hyoung Seob Park, Myung Jin Cha, So Ryoung Lee, Jin Kyu Park, Tae Hoon Kim, Jung Myung Lee, Junbeom Park, Hyung Wook Park, Ki Woon Kang, Jaemin Shim, Jae Sun Uhm, Jin Bae Kim, Changsoo Kim, Young Soo Lee, Eue Keun Choi, Boyoung Joung, Jun Kim

Research output: Contribution to journalArticlepeer-review

Abstract

We sought to evaluate the clinical implication of LAE based on left atrial anterior–posterior (LA AP) dimension or LA volume index (LAVI) in Korean patients with atrial fibrillation (AF). We enrolled 8159 AF patients from the CODE-AF registry. The primary outcome was rate of stroke or systemic embolism (SSE). The prevalence of mild, moderate, and severe LAE by LA AP dimension was 30.6%, 18.5%, and 21.4%, and by LAVI (available in 5808 patients) was 15.7%, 12.5% and 37.8%, respectively. Compared with no or mild LAE, patients with significant LAE (moderate to severe LAE, n = 3258, 39.9%) were associated with a higher rate of SSE (2.5% vs. 1.4%, P = 0.001). Multivariable analysis suggested presence of significant LAE by LA AP dimension was associated with a higher risk of SSE in the overall population (HR 1.57, 95% CI: 1.14–2.17, P = 0.005) and in patients using anticoagulants (n = 5836, HR 1.79, 95% CI: 1.23–2.63, P = 0.002). Patients with significant LAE by LAVI were also at higher risk of SSE (HR 1.58, 95% CI: 1.09–2.29, P = 0.017). In conclusion, significant LAE by LA dimension or LAVI was present in 39.9% and 50.2% of AF patients, respectively, and was associated with a higher rate of SSE.

Original languageEnglish
Article number23808
JournalScientific Reports
Volume11
Issue number1
DOIs
StatePublished - Dec 2021

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