MUNICH — Echocardiographically measured left atrial diameter is an independent predictor of long-term cardiovascular mortality risk in a general population of middle-aged men, Jauri A. Laukkanen, M.D., reported at the annual congress of the European Society of Cardiology.
New data from the ongoing Kuopio Ischemic Heart Disease Risk Factor Study indicate that men in the top quartile in terms of left atrial diameter—that is, greater than 43 mm—had a 2.8-fold greater risk of cardiovascular death during 13 years of prospective follow-up than did men with a left atrial diameter less than 39 mm, said Dr. Laukkanen of the University of Kuopio, Finland.
The study involved a representative population-based sample of 863 middle-aged Finnish men who underwent baseline assessment of left atrial diameter and left ventricular mass via M-mode echocardiography. During an average 13-year follow-up, 69 deaths due to cardiovascular disease occurred.
The strongest risk factors for cardiovascular death proved to be left atrial diameter, smoking, family history of coronary heart disease, systolic hypertension, history of MI, and low exercise capacity.
Left atrial diameter remained an independent predictor after adjusting for the other risk factors in a multivariate analysis.
The increased risk associated with left atrial enlargement was largely confined to men in the top quartile in terms of chamber diameter, Dr. Laukkanen said.
The Kuopio experience confirms what echocardiographers at the Mayo Clinic have been saying about the predictive value of left atrial size as a subclinical risk marker, based upon their studies in the Olmsted County, Minn., population.