PMID- 32649644 OWN - NLM STAT- MEDLINE DCOM- 20210623 LR - 20210623 IS - 1473-5598 (Electronic) IS - 0263-6352 (Linking) VI - 38 IP - 12 DP - 2020 Dec TI - Subclinical left atrial dysfunction profiles for prediction of cardiac outcome in the general population. PG - 2465-2474 LID - 10.1097/HJH.0000000000002572 [doi] AB - OBJECTIVE: Echocardiographic definitions of subclinical left atrial dysfunction based on epidemiological data remain scarce. In this population study, we derived outcome-driven thresholds for echocardiographic left atrial function parameters discriminating between normal and abnormal values. METHODS: In 1306 individuals (mean age, 50.7 years; 51.6% women), we echocardiographically assessed left atrial function and LV global longitudinal strain. We derived cut-off values for left atrial emptying fraction (LAEF), left atrial function index (LAFI) and left atrial reservoir strain (LARS) to define left atrial dysfunction using receiver-operating curve threshold analysis. Main outcome was the incidence of cardiac events and atrial fibrillation (AFib) on average 8.5 years later. RESULTS: For prediction of new-onset AFib, left atrial cut-offs yielding the best balance between sensitivity and specificity (highest Youden index) were: LAEF less than 55%, LAFI less than 40.5 and LARS less than 23%. Applying these cut-offs, abnormal LAEF, LAFI and LARS were, respectively, present in 27, 37.1 and 18.1% of the cohort. Abnormal LARS (<23%) was independently associated with higher risk for cardiac events and new-onset AFib (P