Association of Left Atrial Structure and Function with Incident Atrial Fibrillation in Black and White Adults: the ARIC Study

作者：Yuchen Li, Elsayed Z. Soliman, Sristhi Shrestha, Oluseye Ogunmoroti, Faye L. Norby, Daokun Sun, Linzi Li, A M Shah, Lin Y Chen, Álvaro Alonso · 发表于：medRxiv · 年份：2026 · DOI：10.64898/2026.07.08.26357526 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiovascular Function and Risk Factors、Cardiovascular Disease and Adiposity

Background: Black individuals have a lower incidence of atrial fibrillation (AF) than White individuals despite a higher burden of many traditional cardiovascular risk factors. Differences in left atrial (LA) structure and function by race could partly explain the observed pattern of AF risk. Methods: This analysis included 4,576 (978 Black and 3,598 White) participants from the Atherosclerosis Risk in Communities (ARIC) study, followed between 2011 and 2021. The association of selected echocardiographic measures of LA structure and function with AF incidence was evaluated with race-specific Cox proportional hazards models with adjustment for sociodemographic and clinical covariates. Additional analyses assessed whether LA measures attenuated the association between race and incident AF. Results: The analysis included 778 AF cases (113 in Black and 665 in White participants, mean age 75 years). Larger LA size and worse LA function were associated with higher AF risk in both Black and White individuals, with most associations of similar magnitude in both groups, except for a slightly stronger association of LA reservoir strain in Black than White participants (Black: hazard ratio (HR) 0.89, 95% CI 0.86-0.92 per 1% increase; White: HR 0.94, 95% CI 0.92-0.95, p for interaction = 0.01). In the overall sample, White participants showed higher AF risk compared to Black participants (HR 1.59, 95% CI 1.24-2.03). Adjustment for most individual LA measures did not attenuate the associa...