The Aging Process of the Heart: Obesity Is the Main Risk Factor for Left Atrial Enlargement During AgingThe MONICA/KORA (Monitoring of Trends and Determinations in Cardiovascular Disease/Cooperative Research in the Region of Augsburg) Study
Jan Stritzke, MD*,
Marcello Ricardo Paulista Markus, MD*, , ,
Stefanie Duderstadt, MD*,
Wolfgang Lieb, MD*,
Andreas Luchner, MD ,
Angela Döring, MD||,
Ulrich Keil, MD,
Hans-Werner Hense, MD,
Heribert Schunkert, MD*,* for the MONICA/KORA Investigators
* Department of Internal Medicine II, University of Lübeck, Lübeck, Germany
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
Department of Internal Medicine II, University of Regensburg, Regensburg, Germany
|| HelmholtzZentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
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Figure 1 Measurements of Left Atrial Volume
Measurements were performed at end systole in the apical 4-chamber view by planimetry. As the superior border of the atrial outline, a straight line connecting both sides of the mitral valve attachment points to the valve ring was taken. Both the atrial appendage and the pulmonary veins, when visualized, were carefully excluded. Left atrial volume was calculated using the methods of discs (the Simpson rule).
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Figure 2 Prevalence Odds Ratios for Left Atrial Enlargement
Odds ratios with 95% confidence intervals; results of logistic regression model, adjusted for age (risk per decade) and sex.
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Figure 3 Incidence Odds Ratios for Left Atrial Enlargement
Odds ratios with 95% confidence intervals; results of logistic regression model, adjusted for age (risk per decade) and sex.
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Figure 4 Adjusted Mean Values for iLA
Adjusted mean values with 95% confidence intervals as estimated with univariate variance analysis, adjusted for age and sex; p values for comparison with normal-weight normotensive individuals: *p = 0.016 versus normal-weight hypertensive patients; #p < 0.001 versus normal-weight hypertensive patients; p < 0.001 versus obese normotensive individuals. iLA = indexed left atrial volume.
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Figure 5 Adjusted Mean Values for Absolute Changes of iLA
Adjusted mean values with 95% confidence intervals as estimated with univariate variance analysis, adjusted for age, sex, and the baseline measurement of left atrial volume; p values for comparison with normal-weight normotensive individuals: *p = 0.042 versus normal-weight hypertensive patients; #p = 0.012 versus normal-weight hypertensive patients; p = 0.607 versus obese normotensive individuals. iLA = indexed left atrial volume.
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