Associations between physical activity, left atrial size and incident atrial fibrillation: the Tromsø Study 1994–2016
Aims Left atrial (LA) enlargement is an independent risk factor for atrial fibrillation (AF). Interestingly, some athletes have increased risk of AF, which may be linked to LA enlargement; however, little is known about the relationship between LA enlargement and AF risk at moderate-level physical a...
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crjcrbmj:10.1136/openhrt-2021-001823 2024-06-23T07:57:15+00:00 Associations between physical activity, left atrial size and incident atrial fibrillation: the Tromsø Study 1994–2016 Heitmann, Kim Arne Løchen, Maja-Lisa Stylidis, Michael Hopstock, Laila A Schirmer, Henrik Morseth, Bente Helse Nord RHF 2022 http://dx.doi.org/10.1136/openhrt-2021-001823 https://syndication.highwire.org/content/doi/10.1136/openhrt-2021-001823 en eng BMJ https://creativecommons.org/licenses/by/4.0/ Open Heart volume 9, issue 1, page e001823 ISSN 2053-3624 journal-article 2022 crjcrbmj https://doi.org/10.1136/openhrt-2021-001823 2024-05-30T08:19:18Z Aims Left atrial (LA) enlargement is an independent risk factor for atrial fibrillation (AF). Interestingly, some athletes have increased risk of AF, which may be linked to LA enlargement; however, little is known about the relationship between LA enlargement and AF risk at moderate-level physical activity (PA). We aimed to explore the associations between PA, LA size and risk of incident AF, and if PA can attenuate the risk of AF with LA enlargement. Methods This prospective study followed 2479 participants (52.4% female), free from known cardiac pathology, for median 20.2 years. Participants were followed up for hospital-diagnosed AF, confirmed by electrocardiography, from 1994-95 through 2016. At baseline, LA size was evaluated by anteroposterior LA diameter, and PA was self-reported by questionnaire. Results We observed a U-shaped relationship between PA and AF, and moderately active had 32% lower AF risk than inactive (HR adjusted 0.68, 95% CI 0.50 to 0.93). Participants with LA enlargement had 38% higher AF risk compared with participants with normal LA size (HR adjusted 1.38, 95% CI 1.12 to 1.69). However, the increased AF risk with LA enlargement was attenuated by PA; compared with inactive participants with LA enlargement, the AF risk was 45% lower among active with LA enlargement (HR adjusted 0.55, 95% CI 0.39 to 0.79). AF risk in active participants with LA enlargement did not differ from active with normal LA size. These patterns were observed in both men and women, and in participants over/under 65 years. Conclusion Moderate PA was associated with reduced AF risk, and PA attenuated the increased risk of AF with LA enlargement in both men and women and all age groups. Article in Journal/Newspaper Tromsø The BMJ Tromsø Open Heart 9 1 e001823 |
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description |
Aims Left atrial (LA) enlargement is an independent risk factor for atrial fibrillation (AF). Interestingly, some athletes have increased risk of AF, which may be linked to LA enlargement; however, little is known about the relationship between LA enlargement and AF risk at moderate-level physical activity (PA). We aimed to explore the associations between PA, LA size and risk of incident AF, and if PA can attenuate the risk of AF with LA enlargement. Methods This prospective study followed 2479 participants (52.4% female), free from known cardiac pathology, for median 20.2 years. Participants were followed up for hospital-diagnosed AF, confirmed by electrocardiography, from 1994-95 through 2016. At baseline, LA size was evaluated by anteroposterior LA diameter, and PA was self-reported by questionnaire. Results We observed a U-shaped relationship between PA and AF, and moderately active had 32% lower AF risk than inactive (HR adjusted 0.68, 95% CI 0.50 to 0.93). Participants with LA enlargement had 38% higher AF risk compared with participants with normal LA size (HR adjusted 1.38, 95% CI 1.12 to 1.69). However, the increased AF risk with LA enlargement was attenuated by PA; compared with inactive participants with LA enlargement, the AF risk was 45% lower among active with LA enlargement (HR adjusted 0.55, 95% CI 0.39 to 0.79). AF risk in active participants with LA enlargement did not differ from active with normal LA size. These patterns were observed in both men and women, and in participants over/under 65 years. Conclusion Moderate PA was associated with reduced AF risk, and PA attenuated the increased risk of AF with LA enlargement in both men and women and all age groups. |
author2 |
Helse Nord RHF |
format |
Article in Journal/Newspaper |
author |
Heitmann, Kim Arne Løchen, Maja-Lisa Stylidis, Michael Hopstock, Laila A Schirmer, Henrik Morseth, Bente |
spellingShingle |
Heitmann, Kim Arne Løchen, Maja-Lisa Stylidis, Michael Hopstock, Laila A Schirmer, Henrik Morseth, Bente Associations between physical activity, left atrial size and incident atrial fibrillation: the Tromsø Study 1994–2016 |
author_facet |
Heitmann, Kim Arne Løchen, Maja-Lisa Stylidis, Michael Hopstock, Laila A Schirmer, Henrik Morseth, Bente |
author_sort |
Heitmann, Kim Arne |
title |
Associations between physical activity, left atrial size and incident atrial fibrillation: the Tromsø Study 1994–2016 |
title_short |
Associations between physical activity, left atrial size and incident atrial fibrillation: the Tromsø Study 1994–2016 |
title_full |
Associations between physical activity, left atrial size and incident atrial fibrillation: the Tromsø Study 1994–2016 |
title_fullStr |
Associations between physical activity, left atrial size and incident atrial fibrillation: the Tromsø Study 1994–2016 |
title_full_unstemmed |
Associations between physical activity, left atrial size and incident atrial fibrillation: the Tromsø Study 1994–2016 |
title_sort |
associations between physical activity, left atrial size and incident atrial fibrillation: the tromsø study 1994–2016 |
publisher |
BMJ |
publishDate |
2022 |
url |
http://dx.doi.org/10.1136/openhrt-2021-001823 https://syndication.highwire.org/content/doi/10.1136/openhrt-2021-001823 |
geographic |
Tromsø |
geographic_facet |
Tromsø |
genre |
Tromsø |
genre_facet |
Tromsø |
op_source |
Open Heart volume 9, issue 1, page e001823 ISSN 2053-3624 |
op_rights |
https://creativecommons.org/licenses/by/4.0/ |
op_doi |
https://doi.org/10.1136/openhrt-2021-001823 |
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Open Heart |
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9 |
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1 |
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e001823 |
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1802650787953770496 |