Andersen DM, Sengeløv M, Olsen FJ, et al. - LAVImin (minimum left atrial volume indexed to body surface area) was identified to be an independent predictor of incident heart failure (HF) in the general population. LAVImax (maximum left atrial volume indexed to body surface area), presently the sole left atrial (LA) measure in a routine echocardiographic assessment, was not an independent predictor of incident HF.

• This large general population study (n=2221) was conducted to assess LA parameters as analyzed on transthoracic echocardiography as predictors of incident HF in a community cohort.

• Echocardiography was performed, and maximum and minimum LA volumes indexed to body surface area (LAVImax and LAVImin) were recorded and the LA emptying fraction (LAEF) and LA expansion index (LAEI) were estimated.

• A diagnosis of incident HF was made in 10% of participants during follow-up (median 15.8 years, IQR: 11.3-16.2 years).

• A larger LAVImax and LAVImin and a lower LAEF and LAEI was detected in those diagnosed with HF during follow-up vs those without HF.

• LAVImax, LAVImin, LAEF and LAEI were shown to be predictors of incident HF, in unadjusted analysis.

• Post-multivariable adjustment, only LAVImin, continued to be an independent predictor of incident HF (HR per 1 SD increase: 1.22 (1.01-1.47), p=0.038).