title: Association between diastolic dysfunction and future atrial fibrillation in the Tromsø Study from 1994 to 2010.
abstract: OBJECTIVE
  To investigate the association between echocardiographic measurements with emphasis on diastolic dysfunction and risk of atrial fibrillation (AF) in a population-based cohort study.
  
  
  METHODS
  We followed 2406 participants from the Tromsø Study from 1994 to 2010. Left atrial (LA) size and mitral Doppler indices as measured by echocardiography were used for evaluating diastolic dysfunction. Information concerning age, systolic blood pressure, height, heart rate, body mass index, total and high-density lipoprotein cholesterol, self-reported use of alcohol, smoking, coffee, physical activity, antihypertensive treatment, prevalent coronary heart disease, valvular heart disease, heart failure, hypertrophy, diabetes and palpitations were obtained at baseline. The outcome measure was clinical AF, documented by an ECG.
  
  
  RESULTS
  AF was detected in 462 subjects (193 women). Mean age at baseline was 62.6 years. Incidence rate of clinical AF was 12.6 per 1000 person-years. In multivariable Cox proportional hazards regression analysis, moderately enlarged LA was associated with 60% (95% CI 1.2 to 2.0) increased risk of AF. Severely enlarged LA had HR for AF of 4.2 (95% CI 2.7 to 6.5) with p value for linear trend <0.001, and the association was similar in both sexes. Abnormal mitral Doppler flow adjusted for predictor variables did not show a statistically significant association with AF risk. However, when LA size was also adjusted for, the risk of AF increased by 30% (95% CI 1.0 to 1.6).
  
  
  CONCLUSIONS
  Our findings suggest that enlarged LA as a measure for diastolic dysfunction is a significant risk factor for AF in both sexes, and adding measures of abnormal diastolic flow increased the predictive ability significantly.
authors.affiliation: Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Sweta
authors.initials: S
authors.lastname: Tiwari
authors.affiliation: Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway Department of Cardiology, The University Hospital of North Norway, Tromsø, Norway.
authors.forename: Henrik
authors.initials: H
authors.lastname: Schirmer
authors.affiliation: Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Bjarne K
authors.initials: BK
authors.lastname: Jacobsen
authors.affiliation: Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Laila A
authors.initials: LA
authors.lastname: Hopstock
authors.affiliation: Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Audhild
authors.initials: A
authors.lastname: Nyrnes
authors.affiliation: Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Heggelund
authors.affiliation: Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Inger
authors.initials: I
authors.lastname: Njølstad
authors.affiliation: Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway Department of Neurology and Neurophysiology, The University Hospital of North Norway, Tromsø, Norway.
authors.forename: Ellisiv B
authors.initials: EB
authors.lastname: Mathiesen
authors.affiliation: Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Maja-Lisa
authors.initials: ML
authors.lastname: Løchen
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D001294:Attitude to Health; D008076:Cholesterol, HDL / Q000032:analysis; D015331:Cohort Studies; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D054144:Heart Failure, Diastolic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology*; D009043:Motor Activity; D009664:Norway / Q000453:epidemiology; D009929:Organ Size; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL