Abstract Background Atrial fibrillation is the most common rhythm disorder in the world. Determining the pathoanatomical effects of atrial fibrillation will enable us to better understand the disease process. Purpose According to our hypothesis, adding indexed right atrial volume parameters to the indexed left atrial volume measurement can provide incremental information. Method A total of 416 patients were included in the study. After the diagnosis of atrial fibrillation, in addition to routine echocardiographic parameters, Indexed Systolic Left Atrial Volume Area Length (LA Esv AL), Left Atrial Volume Simpson (LA Esv Mod), Indexed Systolic Right Atrial Volume Area Length (RA Esv AL), Right Atrial Volume Simpson (RA Esv Mod) measurements were also performed . Patients have been followed about 12 years from the index case. Cluster analysis was performed according to similarity of echocardiographic parameters and demographic parameters. As a result of the analysis, patients were divided into two clusters. The cut-off values of the variables (age and echo parameters) that were significant between clusters were analyzed with ROC curve. Youden J index was used to determine cut-off values. Hazard Ratio was calculated by performing Cox regression analysis for death, heart failure and stroke according to the determined cut-off values. Results A total of 413 patients were included in the study (mean age 69.93± 12.14 years). The average follow-up period was 10 years. 281 patient experienced adverse event (death, stroke, heart failure). After adjustment several parameters (age, LVEF and comorbidities ) enlargement of LA Esv Mod and RA Esv Mod together was associated with stroke than one atrial enlargement alone (Picture 1); adjusted HR, 4,31 95% CI, 2,03-9,17; P .001 , for death; LA Esv AL and RA Esv AL was associated with endpoint (Picture 2); HR, 6,41 95% CI, 4,03-10,2; P .001 , for heart failure LA Esv AL and RA Esv AL was associated with end point; HR, 7,26 95% CI, 4,33-12,19; P .001. LA and RA volume enlargement was found better predictiv than LA atrial volume alone. Conclusion In patients with atrial fibrillation, left atrial enlargement accompanied by right atrial enlargement are associated with long-term poor outcomes. This study shows that indexed right atrial volume measurement has an incremental value when combined with the left atrial volume measurement in patients with atrial fibrillation.
Böyük et al. (2024) studied this question.