Investigating Left Atrial Diameter and Heart Failure Onset in Middle-Aged and Elderly: A Retrospective-Prospective Study

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2025-03-07 DOI:10.1002/clc.70085

Ai Wang, Huilin Hu, Dai Zhang, Gang Qian, Haihua Pan, Changlin Zhai, Yan Yan

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Abstract

Background

Left atrium (LA) is an integral component of left heart remodeling, reflecting hemodynamics and ventricular status. It remains uncertain whether left atrial diameter (LAD) can be utilized for predicting and evaluating the occurrence of heart failure (HF) in middle-aged and elderly individuals.

Methods

The study aimed to explore the correlation between LAD and HF in middle-aged and elderly individuals, elucidating the timing of occurrence HF in relation to LAD. The retrospective-prospective study investigated 4025 patients who underwent echocardiography at Zhongshan Hospital's Cardiovascular Department from January 2015 to December 2017. Patients were continuously monitored for HF until January 31, 2024. Cox regression analyses related baseline LAD to HF incidence, adjusted for known risk factors.

Results

A total of 4025 individuals (mean age: 55 years, 45.29% male) were studied, spanning ages 45–91. Fifty-one developed HF during a median follow-up of 4.36 years. Cox regression model demonstrated the association between HF and LAD (HR = 5.721, 95% CI 3.768–8.687, p < 0.001) even after adjusting for covariates (age, weight, eGFR, HDL-C, lymphocyte count, systolic blood pressure, FPG, HbA1C, waist circumference, hip circumference, valvular disease history, atrial fibrillation history).

Conclusions

The link between LAD and future HF occurrence risk among middle-aged and older adults shows a dose–response pattern. This relationship persists post-adjustment for HF-related factors, highlighting the predictive value of LAD in forecasting HF incidence.

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中老年人左房内径与心力衰竭发病关系的回顾性前瞻性研究

背景左心房（LA）是左心重塑的一个组成部分，反映了血液动力学和心室状态。左心房直径（LAD）是否可用于预测和评估中老年人心力衰竭（HF）的发生仍不确定。方法该研究旨在探讨 LAD 与中老年人心力衰竭之间的相关性，阐明心力衰竭发生的时间与 LAD 的关系。该回顾性-前瞻性研究调查了2015年1月至2017年12月在中山医院心血管内科接受超声心动图检查的4025名患者。在2024年1月31日之前，对患者进行了持续的心房颤动监测。Cox回归分析将基线LAD与心房颤动发病率相关联，并对已知风险因素进行调整。结果共有4025人（平均年龄：55岁，45.29%为男性）接受了研究，年龄跨度为45-91岁。在中位 4.36 年的随访期间，51 人患上了心房颤动。Cox 回归模型显示，即使调整了协变量（年龄、体重、eGFR、HDL-C、淋巴细胞计数、收缩压、FPG、HbA1C、腰围、臀围、瓣膜病史、心房颤动史），HF 与 LAD 之间仍存在关联（HR = 5.721，95% CI 3.768-8.687，p <0.001）。结论 LAD 与中老年人未来发生高血压风险之间的关系呈现剂量反应模式。在调整了心房颤动相关因素后，这种关系依然存在，这凸显了 LAD 在预测心房颤动发病率方面的预测价值。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.