Left atrial size and echocardiographic diastolic parameters as predictors of incident atrial fibrillation in older hospitalized patients

• DOI: 10.1007/s40520-025-02936-6
• Publication Date: 2025-02-14T18:54:25Z
• Authors: Yan Yin; Yanguang Li; Lili Wang; Qiaoyuan Li; Xu Liu; Zhipeng Hu; Jiawei Zhang; Tao Zhang; Zhuo Liang; ShaoMin Chen; Yunlong Wang

Abstract Background The associations between left atrial (LA) size, echocardiographic diastolic parameter (E/A ratio), and incident fibrillation (AF) in older inpatients remain underexplored. Aims This study aimed to evaluate the relationship LA E/A ratio, AF risk hospitalized patients. Methods Between January 2015 May 2023, a total of 2,615 (aged ≥ 65 years) were enrolled this retrospective longitudinal study. Left diameter (LAD) ratio measured using transthoracic echocardiography. Results Over median follow-up 844 days (IQR: 331–1355 days), 209 patients (8.0%) experienced at least one AF. After adjusting for covariates, large high significantly associated with AF, an 11% increase each 1 mm LAD over 35 (adjusted HR: 1.11, 95% CI: 1.10–1.13) 30% increased per standard deviation when exceeded 0.65 1.30, 1.23–1.37), P < 0.001. influence size on was more pronounced younger subgroup adults. Incorporating ratios into CHA2DS2-VASc score improved its predictive accuracy (AUC = 0.168, 0.001). Discussion shows that are key predictors patients, age influencing their value. these factors enhances stratification highlights need early screening group. Conclusions In individuals. provide incremental value beyond score. Graphical LA, atrium; ASE: American Society Echocardiography; E, mitral inflow velocity phase; A, late AF: Atrial Fibrillation.