Clinical InvestigationImaging and Diagnostic TestingLeft atrial diameter as an independent predictor of first clinical cardiovascular events in middle-aged and elderly adults: The Strong Heart Study (SHS)
Section snippets
Participants
The SHS is a population-based survey of risk factors for cardiovascular morbidity and mortality in 13 American Indian communities in Arizona, Oklahoma, South Dakota, and North Dakota.14, 15 Tribal members aged 45 to 74 years were recruited from all eligible individuals for an initial examination between July 1989 and January 1992. Baseline assessment of subjects included standardized measurement of seated blood pressure, aspects of body habitus, and fasting glucose, creatinine, lipid, and
Results
Clinical and echocardiographic characteristics of the study cohort are presented in Table I. Approximately one sixth of subjects had LA enlargement, and these individuals were older than those with normal LA diameter and were more often women. They also had a greater mean body mass index and, with the exception of smoking and total cholesterol/HDL-C, a higher prevalence of every traditional risk factor assessed than those with normal atria. Similarly, they exhibited greater frequencies of LV
Discussion
In this population-based cohort of middle-aged and elderly adults free of clinical cardiovascular disease, LA diameter proved to be an independent risk factor for incident cardiovascular events. This relationship was observed both when LA diameter was considered continuously, and when it was dichotomized based on previously derived sex-specific partition values.20 Importantly, LA diameter was 1 of 3 independent echocardiographic predictors of cardiovascular events, along with LV mass index and
References (35)
- et al.
Relation of fibrinogen to cardiovascular events is independent of preclinical cardiovascular disease: the Strong Heart Study
Am Heart J
(2003) - et al.
Prediction of risk for first age-related cardiovascular events in an elderly population: the incremental value of echocardiography
J Am Coll Cardiol
(2003) - et al.
M-mode echocardiographic predictors of six- to seven-year incidence of coronary heart disease, stroke, congestive heart failure, and mortality in an elderly cohort (The Cardiovascular Health Study)
Am J Cardiol
(2001) - et al.
Best method in clinical practice and in research studies to determine left atrial size
Am J Cardiol
(1999) - et al.
How should left atrial size be reported? Comparative assessment with use of multiple echocardiographic methods
Am Heart J
(2004) - et al.
Reference values for echocardiographic measurements in urban and rural populations of differing ethnicity: the Strong Heart Study
J Am Soc Echocardiogr
(2001) - et al.
Relations of left ventricular filling to systolic chamber and myocardial contractility in hypertensive patients with left ventricular hypertrophy: the PRESERVE study
Am J Cardiol
(1999) - et al.
Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings
Am J Cardiol
(1986) - et al.
Effect of growth on variability of left ventricular mass: assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk
J Am Coll Cardiol
(1995) - et al.
Left ventricular mass and body size in normotensive children and adults. Assessment of allometric relation and impact of overweight
J Am Coll Cardiol
(1992)
Problems in echocardiographic volume determinations: echocardiographic-angiographic correlations in the presence or absence of asynergy
Am J Cardiol
Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease
J Am Coll Cardiol
Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden
Am J Cardiol
Relationship between left ventricular wall thickness and left atrial size: comparison with other measures of diastolic function
J Am Soc Echocardiogr
Prediction of paroxysmal atrial fibrillation in patients with congestive heart failure: a prospective study
J Am Coll Cardiol
Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)
JAMA
C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women
N Engl J Med
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This study was supported by grants U01-HL41642, U01-HL41652, and U01-HL41654; by Career Development Award K23-HL070854 (Dr Kizer) from the National Heart, Lung, and Blood Institute, Bethesda, MD; and by grant M10RR0047 (GCRC) from the National Institutes of Health, Bethesda, Md.
The opinions expressed in this article are those of the authors and do not necessarily reflect the views of the Indian Health Service.