Prognostic importance of left atrial size measured by non-contrast cardiac computed tomography – A DANCAVAS study

Fredgart, Maise Høigaard; Lindholt, Jes Sanddal; Brandes, Axel; Steffensen, Flemming Hald; Frost, Lars; Lambrechtsen, Jess; Karon, Marek; Busk, Martin; Urbonavičienė, Gražina; Egstrup, Kenneth; Diederichsen, Axel Cosmus Pyndt

doi:10.1016/j.ijcard.2020.12.029

Cited by 7 publications

(7 citation statements)

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“…The computed tomography (CT) specifications are provided in the supplementary material ( Supplementary Data 1 ) and have previously been described in detail. 15) Using a SyngoVia (Siemens Healthcare Solutions) workstation, 7 trained radiographers, blinded to clinical data, measured heart valve calcification scores using the Agatston method. 9) MAC was defined as calcium deposition at the junction between the left atrium and left ventricle at the level of the mitral annulus, excluding calcium in the mitral leaflets; aortic valve; left main, circumflex, and right coronary artery; and leads ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

Mitral Annulus Calcification and Cardiac Conduction Disturbances: A DANCAVAS Sub-study

Rasmussen

Fredgart

Lindholt

et al. 2022

J Cardiovasc Imaging

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BACKGROUND Due to its location very close to the bundle of His, mitral annulus calcification (MAC) might be associated with the development of atrioventricular (AV) conduction disturbances. This study assessed the association between MAC and AV conduction disturbances identified by cardiac implantable electronic device (CIED) use and electrocardiographic parameters. The association between MAC and traditional cardiovascular risk factors was also assessed. METHODS This cross-sectional study analyzed 14,771 participants, predominantly men aged 60–75 years, from the population-based Danish Cardiovascular Screening trial. Traditional cardiovascular risk factors were obtained. Using cardiac non-contrast computed tomography imaging, MAC scores were measured using the Agatston method and divided into absent versus present and score categories. CIED implantation data were obtained from the Danish Pacemaker and Implantable Cardioverter Defibrillator Register. A 12-lead electrocardiogram was available for 2,107 participants. Associations between MAC scores and AV conduction disturbances were assessed using multivariate regression analyses. RESULTS MAC was present in 22.4% of the study subjects. Participants with pacemakers for an AV conduction disturbance had significantly higher MAC scores (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.01–1.23) than participants without a CIED, whereas participants with a CIED for other reasons did not. Prolonged QRS-interval was significantly associated with the presence of MAC (OR, 1.45; 95% CI, 1.04–2.04), whereas prolonged PQ-interval was not. Female sex and most traditional cardiovascular risk factors were significantly associated with high MAC scores. CONCLUSIONS MAC was associated with AV conduction disturbances, which could improve our understanding of the development of AV conduction disturbances.

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Section: Methodsmentioning

confidence: 99%

Mitral Annulus Calcification and Cardiac Conduction Disturbances: A DANCAVAS Sub-study

Rasmussen

Fredgart

Lindholt

et al. 2022

J Cardiovasc Imaging

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“…Left atrial (LA) size is associated with adverse cardiovascular events and has been recognised to be an independent predictor of cardiovascular outcome [ 1 , 2 , 3 , 4 ]. As an increased LA size is connected to the risk of atrial fibrillation and heart failure, the risk factors causing LA dilation would therefore be expected to be similar to those leading to atrial fibrillation and heart failure.…”

Section: Introductionmentioning

confidence: 99%

Association of Left Atrial Size Measured by Non-Contrast Computed Tomography with Cardiovascular Risk Factors—The Danish Cardiovascular Screening Trial (DANCAVAS)

et al. 2022

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Left atrium (LA) size is associated with adverse cardiovascular events. The purpose of this study was to investigate the association of LA enlargement measured by non-contrast CT (NCCT) with traditional cardiovascular risk factors. Individuals aged 60–75 years from the population-based multicentre Danish Cardiovascular Screening (DANCAVAS) trial were included in this cross-sectional study. The LA was manually traced on the NCCT scans, and the largest cross-section area was indexed to body surface area. All traditional risk factors were recorded, and a subgroup received an echocardiographic examination. We enrolled 14,987 individuals. Participants with known cardiovascular disease or lacking measurements of LA size or body surface area were excluded, resulting in 10,902 men for the main analysis and 616 women for a sensitivity analysis. Adjusted multivariable analysis showed a significantly increased indexed LA size by increasing age and pulse pressure, while smoking, HbA1c, and total cholesterol were associated with decreased indexed LA size. The findings were confirmed in a supplementary analysis including left ventricle ejection fraction and mass. In this population-based cohort of elderly men, an association was found between age and pulse pressure and increasing LA size. Surprisingly, smoking, HbA1c, and total cholesterol were associated with a decrease in LA size. This indicates that the pathophysiology behind atrial cardiomyopathy is not only reflected by enlargement, but also shrinking.

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“…Left atrial enlargement (LAE) is related to high blood volume status (i.e., mitral regurgitation and elite endurance athletes) (13,14) and elevated left ventricular (LV) diastolic pressure (i.e., obesity, hypertension, and great LV mass) (15)(16)(17). LAE is a precursor of left atrial dysfunction and has been associated with incident atrial fibrillation, ischemic stroke, and cardiovascular events in middle-and old-aged individuals (18)(19)(20)(21). The prevalence of LAE is increased with aging, (18) and, in young adults, LAE is usually observed in those undergoing rigorous physical training, particularly accumulated lifetime training >3,600 h (22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

Machine Learning for Electrocardiographic Features to Identify Left Atrial Enlargement in Young Adults: CHIEF Heart Study

Hsu

Liu

et al. 2022

Front. Cardiovasc. Med.

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BackgroundLeft atrial enlargement (LAE) is associated with cardiovascular events. Machine learning for ECG parameters to predict LAE has been performed in middle- and old-aged individuals but has not been performed in young adults.MethodsIn a sample of 2,206 male adults aged 17–43 years, three machine learning classifiers, multilayer perceptron (MLP), logistic regression (LR), and support vector machine (SVM) for 26 ECG features with or without 6 biological features (age, body height, body weight, waist circumference, and systolic and diastolic blood pressure) were compared with the P wave duration of lead II, the traditional ECG criterion for LAE. The definition of LAE is based on an echocardiographic left atrial dimension > 4 cm in the parasternal long axis window.ResultsThe greatest area under the receiver operating characteristic curve is present in machine learning of the SVM for ECG only (77.87%) and of the MLP for all biological and ECG features (81.01%), both of which are superior to the P wave duration (62.19%). If the sensitivity is fixed to 70–75%, the specificity of the SVM for ECG only is up to 72.4%, and that of the MLP for all biological and ECG features is increased to 81.1%, both of which are higher than 48.8% by the P wave duration.ConclusionsThis study suggests that machine learning is a reliable method for ECG and biological features to predict LAE in young adults. The proposed MLP, LR, and SVM methods provide early detection of LAE in young adults and are helpful to take preventive action on cardiovascular diseases.

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Prognostic importance of left atrial size measured by non-contrast cardiac computed tomography – A DANCAVAS study

Cited by 7 publications

References 33 publications

Mitral Annulus Calcification and Cardiac Conduction Disturbances: A DANCAVAS Sub-study

Mitral Annulus Calcification and Cardiac Conduction Disturbances: A DANCAVAS Sub-study

Association of Left Atrial Size Measured by Non-Contrast Computed Tomography with Cardiovascular Risk Factors—The Danish Cardiovascular Screening Trial (DANCAVAS)

Machine Learning for Electrocardiographic Features to Identify Left Atrial Enlargement in Young Adults: CHIEF Heart Study

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