Factors Associated With Left Atrial Remodeling in the General Population.
BACKGROUND
Although contributors to remodeling of the left ventricle (LV) have been well studied in general population cohorts, few data are available describing factors influencing changes in left atrial (LA) structure.


RESULTS
Maximum LA volume was determined by cardiac magnetic resonance imaging among 748 participants in the Dallas Heart Study at 2 visits a mean of 8 years apart. Associations of changes in LA volume (ΔLAV) with traditional risk factors, biomarkers, LV geometry, and remodeling by cardiac magnetic resonance imaging and detailed measurements of global and regional adiposity (by magnetic resonance imaging and dual-energy x ray absorptiometry) were assessed using multivariable linear regression. Greater ΔLAV was independently associated with black and Hispanic race/ethnicity, change in systolic blood pressure, LV mass and ΔLV mass, N-terminal probrain natriuretic peptide and change in N-terminal probrain natriuretic peptide, and body mass index (P<0.05 for each). In subanalyses, the associations of ΔLAV with LV mass parameters were driven by associations with baseline and ΔLV end diastolic volume (P<0.0001 for each) and not wall thickness (P=0.21). Associations of ΔLAV with body mass index were explained exclusively by associations with visceral fat mass (P=0.002), with no association seen between ΔLAV and subcutaneous abdominal fat (P=0.47) or lower body fat (P=0.30).


CONCLUSIONS
Left atrial dilatation in the population is more common in black and Hispanic than in white individuals and is associated with parallel changes in the LV. LA dilatation may be mediated by blood pressure control and the development of visceral adiposity.
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas.
Walter
W
Oliver
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas.
Gwendolyn
G
Matthews
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas.
Colby R
CR
Ayers
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas.
Sonia
S
Garg
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas.
Sachin
S
Gupta
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas.
Ian J
IJ
Neeland
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas.
Mark H
MH
Drazner
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas.
Jarett D
JD
Berry
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas.
Susan
S
Matulevicius
From the Cardiovascular Division, Department of Medicine (W.O., G.M., C.R.A., S. Garg, S. Gupta, I.J.N., M.H.D., J.D.B., S.M., J.A.d.L.), and Department of Clinical Sciences (C.R.A., J.D.B.), University of Texas Medical Center, Dallas. james.delemos@utsouthwestern.edu.
James A
JA
de Lemos
D015502:Absorptiometry, Photon; D050154:Adiposity; D000328:Adult; D001741:Black or African American; D016279:Atrial Function, Left; D064752:Atrial Remodeling; D001794:Blood Pressure; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D050152:Intra-Abdominal Fat; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology; D012307:Risk Factors; D013781:Texas / Q000208:ethnology; D013997:Time Factors; D044465:White People
ethnic groups; left atrial volume index; left atrium; magnetic resonance imaging; obesity; race; remodeling