title: New-onset left atrial enlargement in a general population.
abstract: Increased left atrium diameter (LAD) is associated with elevated risk of cardiovascular morbidity and mortality. We evaluated new-onset left atrium enlargement (LAE) and their correlates over a 10-year period in participants of the general population enrolled in the Pressioni Monitorate e Loro Associazioni study.
  
  
  
  The study included 1045 participants with normal LAD at baseline evaluation having a readable echocardiogram at the end of follow-up. Cut-points for abnormal LAD were derived from reference values recommended by American Society of Echocardiography.
  
  
  
  Over a 10-year period, 123 participants (11.8%) progressed to LAE. The incidence of new-onset LAE increased significantly from the lowest to the highest tertile of baseline office, home and 24-h blood pressure (BP); BMI; fasting blood glucose and left ventricular mass index (LVMI). In multivariate analysis, baseline LAD [odds ratio (OR) 3.18, confidence interval (CI) 2.26-4.47, P < 0.001], female sex (OR 3.68, CI 2.20-6.18, P < 0.001), office SBP (OR 1.36, CI 1.08-1.70, P = 0.008), BMI (OR 1.35, CI 1.07-1.69, P = 0.01 and LVMI (OR 1.29, CI 1.01-1.64, P = 0.04) emerged as key correlates of new-onset LAE.
  
  
  
  The study shows that in the population, long-term changes from normal LAD to LAE are independently driven by several risk factors such as the female sex and an increased baseline LAD, BMI, LVMI and BP, with no predictive superiority of home and ambulatory versus office values. Preventing BP elevations, overweight/obesity and left ventricular hypertrophy may thus all be important for LAE prevention.
authors.affiliation: aDepartment of Medicine and Surgery, University of Milano-Bicocca, Milano bIstituto Auxologico Italiano IRCCS cDepartment of Clinical Sciences and Community Health, University of Milano dFondazione Ospedale Maggiore Policlinico, Milano, Italy eUniversity Clinical Hospital Centre 'Dragisa Misovic', Belgrade, Serbia fIRCCS Multimedica, Sesto San Giovanni, Milano, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Bombelli
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Rita
authors.initials: R
authors.lastname: Facchetti
authors.forename: Carla
authors.initials: C
authors.lastname: Sala
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.forename: Gianmaria
authors.initials: G
authors.lastname: Brambilla
authors.forename: Annalisa
authors.initials: A
authors.lastname: Re
authors.forename: Paolo
authors.initials: P
authors.lastname: Villa
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D006332:Cardiomegaly / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology / Q000517:prevention & control; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D001786:Blood Glucose