PMID- 35191736
OWN - NLM
STAT- MEDLINE
DCOM- 20220427
LR  - 20230502
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Print)
IS  - 0033-8419 (Linking)
VI  - 303
IP  - 2
DP  - 2022 May
TI  - Change in Left Atrioventricular Coupling Index to Predict Incident Atrial 
      Fibrillation: The Multi-Ethnic Study of Atherosclerosis (MESA).
PG  - 317-326
LID - 10.1148/radiol.210315 [doi]
AB  - Background Left atrial (LA) and left ventricular (LV) structural and functional 
      parameters have independent prognostic values as predictors of atrial 
      fibrillation (AF). Purpose To investigate the prognostic value of a left 
      atrioventricular coupling index (LACI) and average annualized change in LACI 
      (hereafter, DeltaLACI) measured by cardiac MRI to predict incident AF in a 
      population-based sample from the Multi-Ethnic Study of Atherosclerosis (MESA). 
      Materials and Methods In a secondary analysis of the prospective MESA, 1911 study 
      participants without clinically recognized AF and cardiovascular disease at 
      baseline had LACI assessed with cardiac MRI at baseline (examination 1, 
      2000-2002) and 10 years later (examination 5, 2010-2012). LACI was defined as the 
      ratio of LA to LV end-diastolic volumes. Univariable and multivariable Cox 
      proportional hazard models were used to evaluate the associations of LACI and 
      average DeltaLACI with incident AF. Results Among the 1911 participants (mean age, 59 
      years +/- 9 [standard deviation]; 907 men), 87 incident AF events occurred over 3.9 
      years +/- 0.9 after the second imaging (examination 5). After adjustment for 
      traditional risk factors, greater LACI and DeltaLACI were independently associated 
      with AF (hazard ratio, 1.69 [95% CI: 1.46, 1.96] and 1.71 [95% CI: 1.50, 1.94], 
      respectively; both P < .001). Adjusted models for LACI and DeltaLACI showed 
      improvement in model discrimination compared with currently used AF risk score 
      (Cohort for Heart and Aging Research in Genomic Epidemiology-Atrial Fibrillation, 
      or CHARGE-AF, score) model (area under receiver operating characteristic curve 
      [AUC], 0.78 vs 0.74; and AUC, 0.80 vs 0.74, respectively; both P < .001); and to 
      the final model including individual LA or LV parameters for predicting AF 
      incidence (AUC, 0.78 vs 0.76; and AUC, 0.80 vs 0.78, respectively; both P < 
      .001). Conclusion Atrioventricular coupling (left atrioventricular coupling index 
      [LACI]) and coupling change (annual change in LACI) were strong predictors for 
      atrial fibrillation (AF) in a multiethnic population. Both had incremental 
      prognostic value for predicting AF over traditional risk factors, and superior 
      discrimination compared with the Cohort for Heart and Aging Research in Genomic 
      Epidemiology-Atrial Fibrillation, or CHARGE-AF, score and to individual left 
      atrial or left ventricular parameters. (c) RSNA, 2022 Online supplemental material 
      is available for this article. See also the editorial by Leiner in this issue.
FAU - Pezel, Theo
AU  - Pezel T
AUID- ORCID: 0000-0002-6716-8444
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - Ambale-Venkatesh, Bharath
AU  - Ambale-Venkatesh B
AUID- ORCID: 0000-0002-2330-2373
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - Quinaglia, Thiago
AU  - Quinaglia T
AUID- ORCID: 0000-0001-9099-3007
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - Heckbert, Susan R
AU  - Heckbert SR
AUID- ORCID: 0000-0002-7100-512X
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - Kato, Yoko
AU  - Kato Y
AUID- ORCID: 0000-0002-4328-1987
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - de Vasconcellos, Henrique Doria
AU  - de Vasconcellos HD
AUID- ORCID: 0000-0002-9758-2240
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - Wu, Colin O
AU  - Wu CO
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - Post, Wendy S
AU  - Post WS
AUID- ORCID: 0000-0002-8655-5204
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - Henry, Patrick
AU  - Henry P
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - Bluemke, David A
AU  - Bluemke DA
AUID- ORCID: 0000-0002-8323-8086
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
FAU - Lima, Joao A C
AU  - Lima JAC
AUID- ORCID: 0000-0001-8756-6995
AD  - From the Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 
      600 N Wolfe St, Baltimore, MD 21287-0409 (T.P., B.A.V., T.Q., Y.K., H.D.d.V., 
      C.O.W., W.S.P., J.A.C.L.); Department of Cardiology, Lariboisiere Hospital-APHP, 
      Inserm UMRS 942, University of Paris, Paris, France (T.P., P.H.); Department of 
      Epidemiology, University of Washington, Seattle, Wash (S.R.H.); and University of 
      Wisconsin School of Medicine and Public Health, Madison, Wis (J.A.C.L.).
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20220222
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
SB  - IM
CIN - Radiology. 2022 Feb 22;:213293. PMID: 35191742
MH  - *Atherosclerosis/complications
MH  - *Atrial Fibrillation/diagnostic imaging/epidemiology
MH  - Ethnicity
MH  - Female
MH  - Heart Atria
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
PMC - PMC9081516
COIS- Disclosures of Conflicts of Interest: T.P. No relevant relationships. B.A.V. 
      Institutional grant from Cannon Medical Systems, Myocardial Solutions. T.Q. No 
      relevant relationships. S.R.H. Data safety monitoring board for University at 
      California, San Francisco. Y.K. No relevant relationships. H.D.d.V. Data safety 
      monitoring board at Johns Hopkins. C.O.W. No relevant relationships. W.S.P. NIH 
      grant to Johns Hopkins. P.H. No relevant relationships. D.A.B. Editor-in-chief of 
      Radiology. J.A.C.L. Member of the Radiology editorial board.
EDAT- 2022/02/23 06:00
MHDA- 2022/04/28 06:00
PMCR- 2023/05/01
CRDT- 2022/02/22 12:12
PHST- 2022/02/23 06:00 [pubmed]
PHST- 2022/04/28 06:00 [medline]
PHST- 2022/02/22 12:12 [entrez]
PHST- 2023/05/01 00:00 [pmc-release]
AID - 10.1148/radiol.210315 [doi]
PST - ppublish
SO  - Radiology. 2022 May;303(2):317-326. doi: 10.1148/radiol.210315. Epub 2022 Feb 22.