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Heart Online First, published on May 18, 2015 as 10.1136/heartjnl-2015-307885
Diastolic dysfunction and atrial fibrillation Victoria Delgado, Jeroen J Bax Development of effective atrial fibrillation (AF) prevention strategies has become a research priority to reduce the global burden of this arrhythmia. With an estimated prevalence in 2010 of 8.8 million adults aged >55 years and a projected prevalence of 17.9 million by 2060 in the European Union,1 AF is the most frequent cardiac arrhythmia and is associated with increased morbidity and mortality. Data from several North American and Western European registries provide important information to better understand the epidemiology of AF and form the basis for the development of effective AF preventive interventions. Creation of models that predict the occurrence of AF is one of the first steps to identify the demographic characteristics and cardiovascular risk factors that can be modified or treated to reduce the burden of AF. Furthermore, the assessment of the structural substrate associated with an increased risk of AF (inflammation, fibrosis, structural and electrical remodelling of the left atrium) is also important. The addition of echocardiographic parameters (left atrial (LA) diameter, the sum of diastolic interventricular septal and posterior wall thickness and LV fractional shortening) to the model derived from the Framingham Heart Study slightly improved the discrimination of the model, particularly in individuals with valvular heart disease or heart failure.2 The number of studies evaluating the association between several echocardiographic variables and the risk of AF across different subpopulations is growing and LA size and LV systolic and diastolic dysfunctions are the main focus of those studies. In their Heart paper, Tiwari et al3 provide further evidence by demonstrating that the addition of LA size and LV diastolic function to a number of sociodemographic variables and cardiovascular risk factors increased the ability of the model to predict the occurrence of AF in
Department of Cardiology, Heart and Lung Center, Leiden University Medical Center, Leiden, The Netherlands Correspondence to Dr Victoria Delgado, Department of Cardiology, Heart and Lung Center, Leiden University Medical Center; Albinusdreef 2, Leiden 2300 RC, The Netherlands; [email protected]
2406 participants of the Tromsø study. During the 16-year follow-up, 462 (19%) individuals presented with AF (incidence: 12.6/1000 person years). Severely enlarged left atrium (>2.8 cm/m2) was independently associated with the occurrence of AF (HR 4.2; 95% CI 2.7 to 6.5, p
Heart Online First, published on May 18, 2015 as 10.1136/heartjnl-2015-307885
Diastolic dysfunction and atrial fibrillation Victoria Delgado, Jeroen J Bax Development of effective atrial fibrillation (AF) prevention strategies has become a research priority to reduce the global burden of this arrhythmia. With an estimated prevalence in 2010 of 8.8 million adults aged >55 years and a projected prevalence of 17.9 million by 2060 in the European Union,1 AF is the most frequent cardiac arrhythmia and is associated with increased morbidity and mortality. Data from several North American and Western European registries provide important information to better understand the epidemiology of AF and form the basis for the development of effective AF preventive interventions. Creation of models that predict the occurrence of AF is one of the first steps to identify the demographic characteristics and cardiovascular risk factors that can be modified or treated to reduce the burden of AF. Furthermore, the assessment of the structural substrate associated with an increased risk of AF (inflammation, fibrosis, structural and electrical remodelling of the left atrium) is also important. The addition of echocardiographic parameters (left atrial (LA) diameter, the sum of diastolic interventricular septal and posterior wall thickness and LV fractional shortening) to the model derived from the Framingham Heart Study slightly improved the discrimination of the model, particularly in individuals with valvular heart disease or heart failure.2 The number of studies evaluating the association between several echocardiographic variables and the risk of AF across different subpopulations is growing and LA size and LV systolic and diastolic dysfunctions are the main focus of those studies. In their Heart paper, Tiwari et al3 provide further evidence by demonstrating that the addition of LA size and LV diastolic function to a number of sociodemographic variables and cardiovascular risk factors increased the ability of the model to predict the occurrence of AF in
Department of Cardiology, Heart and Lung Center, Leiden University Medical Center, Leiden, The Netherlands Correspondence to Dr Victoria Delgado, Department of Cardiology, Heart and Lung Center, Leiden University Medical Center; Albinusdreef 2, Leiden 2300 RC, The Netherlands; [email protected]
2406 participants of the Tromsø study. During the 16-year follow-up, 462 (19%) individuals presented with AF (incidence: 12.6/1000 person years). Severely enlarged left atrium (>2.8 cm/m2) was independently associated with the occurrence of AF (HR 4.2; 95% CI 2.7 to 6.5, p
