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Olsen FJ, Biering-Sørensen SR, Reimer Jensen AM, Schnohr P, Jensen GB, Svendsen JH, Møgelvang R, Biering-Sørensen T. Global longitudinal strain predicts atrial fibrillation in individuals without hypertension: A Community-based cohort study. Clin Res Cardiol 2021; 110:1801-1810. [PMID: 34406455 DOI: 10.1007/s00392-021-01921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Global longitudinal strain (GLS) is a sensitive marker of myocardial dysfunction and atrial reservoir function. We sought to evaluate its value for predicting atrial fibrillation (AF) in the general population. METHODS Participants from the Copenhagen City Heart Study examined with echocardiography, including speckle tracking analyses, were included. The endpoint was AF obtained through national registries. Proportional hazards Cox regression was applied, including multivariable adjustments made for CHADS2 and CHARGE-AF risk factors. Abnormal GLS was defined as >-18%. RESULTS The data from 1,309 participants were analyzed. Of those, 153 (12%) developed AF during a median follow-up time of 15.9 years. The follow-up was 100%. The mean age was 57 years, 38% had hypertension, and GLS was - 18%. In unadjusted analysis, GLS was a univariable predictor of outcome (1.08 (1.04-1.13), p < 0.001, per 1% absolute decrease), but did not remain an independent predictor after adjusting for neither CHADS2 nor CHARGE-AF risk factors. However, hypertension modified the relationship between GLS and AF (p for interaction = 0.010), such that GLS only predicted AF in subjects without hypertension. In participants without hypertension, GLS remained an independent predictor of AF after adjusting for CHADS2 and CHARGE-AF (HR = 1.11 (1.03-1.20) and HR = 1.09 (1.01-1.19), respectively). In these participants, an abnormal GLS was associated with a more than twofold increased risk of AF (HR = 2.16 (1.26-3.72). The incidence rate was 3.17 and 6.81 per 1000 person-years for normal vs. abnormal GLS, respectively. CONCLUSION Global longitudinal strain predicts AF in individuals without hypertension from the general population, independently of common risk scores.
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Affiliation(s)
- Flemming Javier Olsen
- The Copenhagen City Heart Study, Frederiksberg, Denmark. .,Department of Cardiology, Cardiovascular Non-Invasive Imaging Research Laboratory, Herlev & Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark.
| | | | - Anne Marie Reimer Jensen
- The Copenhagen City Heart Study, Frederiksberg, Denmark.,Department of Cardiology, Cardiovascular Non-Invasive Imaging Research Laboratory, Herlev & Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study, Frederiksberg, Denmark
| | | | - Jesper Hastrup Svendsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Møgelvang
- The Copenhagen City Heart Study, Frederiksberg, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Research, Faculty of Health and Medical Sciences, University of Southern Denmark, Svendborg, Denmark
| | - Tor Biering-Sørensen
- The Copenhagen City Heart Study, Frederiksberg, Denmark.,Department of Cardiology, Cardiovascular Non-Invasive Imaging Research Laboratory, Herlev & Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900, Hellerup, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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