{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T19:59:45Z","timestamp":1789070385820,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Truncating TTN variants (TTNtv) are the main genetic cause of dilated cardiomyopathy (DCM) and are independently associated with atrial fibrillation (AF). In DCM, AF usually arises from left atrial (LA) remodeling attributable to left ventricular systolic dysfunction. Whether TTNtv are linked to primary LA dysfunction independent of left ventricular systolic dysfunction remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This retrospective, multicenter study evaluated atrial function by strain echocardiography in TTNtv carriers across the left ventricular ejection fraction (LVEF) spectrum and its relationship with AF. Individuals with TTNtv and LVEF \u226550% (TTNtv+\/DCM\u2013) were compared with matched healthy controls, and those with LVEF &lt;50% (TTNtv+\/DCM+) were compared with matched patients with idiopathic, variant\u2010negative DCM (iDCM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 460 participants, 153 carried a TTNtv (87 with LVEF \u226550%, 66 with LVEF &lt;50%). All LA strain parameters were significantly lower in TTNtv+\/DCM\u2013 than in controls (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). In TTNtv+\/DCM+, only LA contractile strain was reduced compared with iDCM (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). LA contractile strain correlated with LVEF only when LVEF was &lt;50% (TTNtv+\/DCM+, r=0.50,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001; iDCM, r=0.47,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). In TTNtv+\/DCM\u2013, all LA strain parameters except contractile strain correlated with LV strain. AF incidence was higher in TTNtv+\/DCM+ (3.15\/100 person\u2010years) than in TTNtv+\/DCM\u2013 (1.48) and iDCM (2.27), though cumulative incidence was not significantly different (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.200).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">LA myopathy, detected by strain imaging, appears early in TTNtv+\/DCM\u2013 individuals and may represent an early phenotypic marker independent of left ventricular systolic dysfunction. When LVEF declines below 50%, atrial dysfunction worsens in parallel. AF was more frequent in TTNtv carriers, supporting further research on LA strain for AF risk stratification within this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047740","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:39:18Z","timestamp":1773139158000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Truncating Variants in\n                    <i>TTN<\/i>\n                    are Associated With Primary Atrial Myopathy"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1975-9132","authenticated-orcid":false,"given":"Daniel","family":"de Castro","sequence":"first","affiliation":[{"name":"CIBERCV","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9010-9856","authenticated-orcid":false,"given":"Diane","family":"Fatkin","sequence":"additional","affiliation":[{"name":"Victor Chang Cardiac Research Institute","place":["Sydney, Australia"]},{"name":"St Vincent\u2019s Hospital","place":["Sydney, Australia"]},{"name":"UNSW Sydney","place":["Sydney, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3233-2283","authenticated-orcid":false,"given":"Enrique","family":"Rodriguez\u2010Rubio","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria Puerta de Hierro \u2010 Segovia de Arana (IDIPHISA)","place":["Majadahonda, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Haddad","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine","place":["Stanford, USA"]},{"name":"Stanford University","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6671-5189","authenticated-orcid":false,"given":"Fernando","family":"Hern\u00e1ndez\u2010Terciado","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Universidad de Navarra","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8029-8358","authenticated-orcid":false,"given":"Anisha","family":"Purohit","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadi P.","family":"Bagherzadeh","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Nair","sequence":"additional","affiliation":[{"name":"Stanford School of Medicine","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aria","family":"Rad","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5026-0475","authenticated-orcid":false,"given":"Vikki A.","family":"Krysov","sequence":"additional","affiliation":[{"name":"Stanford School of Medicine","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5138-5559","authenticated-orcid":false,"given":"Victoria N.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Stanford School of Medicine","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5470-2257","authenticated-orcid":false,"given":"Pablo","family":"Garc\u00eda\u2010Pavia","sequence":"additional","affiliation":[{"name":"CIBERCV; IDIPHISA","place":["Madrid, Spain"]},{"name":"Universidad Francisco de Vitoria and Centro Nacional de Investigaciones Cardiovasculares (CNIC)","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6458-5421","authenticated-orcid":false,"given":"Neal K.","family":"Lakdawala","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaa421"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae298"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2021.3370"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.18179"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCGEN.119.002713"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCGEN.123.004412"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2022-321609"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2022.01.016"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae204"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2021.08.008"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCGEN.121.003480"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2023.05.013"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01241-2"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001193"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.02.003"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pcbi.1004284"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2019.02.032"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.039573"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/jmedgenet-2020-107178"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.119.006832"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.05.004"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2024.07.029"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.abd3079"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.abd7287"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-021-00648-8"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.047740","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:09:39Z","timestamp":1782990579000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.047740"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,3,17]]}},"alternative-id":["10.1161\/JAHA.125.047740"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.047740","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"2025-11-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"eJAHA\/2025\/047740-T"}}