Authors’ reply to: ‘Interpreting early-life BMI burden in the pathway to atrial remodelling’

This Invited Authors’ Reply refers to ‘Interpreting early-life BMI burden in the pathway to atrial remodelling’ by P. Bauer et al. https://doi.org/10.1093/eurjpc/zwag504 We thank MD Tatar et al. for their thoughtful comments and interest in our recently published article, ‘Early life and adulthood risk factors for middle-age P-wave prolongation and left atrial enlargement’, and the Editor-in-Chief for the opportunity to respond.1,2 In their Letter to the Editor, they highlight that the age range of 6–24 years used in our analysis to examine cumulative early-life risk factors for middle-age P-wave duration and left atrial (LA) size encompasses several distinct developmental stages, from pre-pubertal childhood through adolescence to young adulthood. They further suggest that using age- and sex-standardized body mass index (BMI) scores during childhood and adolescence, or separating BMI exposure into developmental periods such as childhood, adolescence, and young adulthood, might further refine our findings and help identify whether a particularly sensitive developmental window exists for atrial remodelling. We agree that this is a valuable and relevant point.