TY - JOUR
T1 - Associations of left atrial function and structure with supraventricular ectopy
T2 - The multi-ethnic study of atherosclerosis
AU - Heckbert, Susan R.
AU - Jensen, Paul N.
AU - Austin, Thomas R.
AU - Chen, Lin Yee
AU - Post, Wendy S.
AU - Venkatesh, Bharath Ambale
AU - Soliman, Elsayed Z.
AU - Floyd, James S.
AU - Sotoodehnia, Nona
AU - Kronmal, Richard A.
AU - Lima, Joao A.C.
N1 - Publisher Copyright:
© 2021 The Authors.
PY - 2021/2/16
Y1 - 2021/2/16
N2 - BACKGROUND: High levels of supraventricular ectopy are associated with greater risk of atrial fibrillation, stroke, and death. Little information is available about differences by race/ethnicity in the extent of supraventricular ectopy, or about whether high levels of supraventricular ectopy are associated with impaired left atrial (LA) function and LA enlargement. METHODS AND RESULTS: In the MESA (Multi-Ethnic Study of Atherosclerosis), 1148 participants (47% men; mean age, 67 years) had cardiovascular magnetic resonance imaging in 2010 to 2012, followed by 14-day ambulatory electrocardiographic monitoring in 2016 to 2018. We analyzed participant characteristics and cardiovascular magnetic resonance measures of LA function and structure in relation to average count of premature atrial contractions (PACs) per hour and average number of runs per day of supraventricular tachycardia. In adjusted regression analyses, older age, male sex, White race, elevated NT-proBNP (N-terminal pro-B-type natriuretic peptide), and a history of clinically detected atrial fibrillation were associated with more PACs/hour. Chinese and Hispanic participants had on average fewer PACs/hour than White participants (Chinese participants, 31% less [95% CI, 8%–49%]; Hispanic participants, 38% less [95% CI, 19%–52%]). Greater LA total emptying fraction was associated with fewer PACs/hour (per SD, 16% fewer PACs/hour [95% CI, 7%–25% fewer PACs/hour]). Larger LA minimum volume was associated with more PACs/hour (per SD, 7% more PACs/hour [95% CI, 2%–13% more PACs/hour]). Associations of LA volumes with runs of supraventricular tachycardia/day were similar in direction but were weaker. CONCLUSIONS: Impaired LA function and LA enlargement were associated with more PACs/hour on extended ambulatory electrocardiographic monitoring. Measurement of supraventricular ectopy may provide information about the extent of atrial myopathy.
AB - BACKGROUND: High levels of supraventricular ectopy are associated with greater risk of atrial fibrillation, stroke, and death. Little information is available about differences by race/ethnicity in the extent of supraventricular ectopy, or about whether high levels of supraventricular ectopy are associated with impaired left atrial (LA) function and LA enlargement. METHODS AND RESULTS: In the MESA (Multi-Ethnic Study of Atherosclerosis), 1148 participants (47% men; mean age, 67 years) had cardiovascular magnetic resonance imaging in 2010 to 2012, followed by 14-day ambulatory electrocardiographic monitoring in 2016 to 2018. We analyzed participant characteristics and cardiovascular magnetic resonance measures of LA function and structure in relation to average count of premature atrial contractions (PACs) per hour and average number of runs per day of supraventricular tachycardia. In adjusted regression analyses, older age, male sex, White race, elevated NT-proBNP (N-terminal pro-B-type natriuretic peptide), and a history of clinically detected atrial fibrillation were associated with more PACs/hour. Chinese and Hispanic participants had on average fewer PACs/hour than White participants (Chinese participants, 31% less [95% CI, 8%–49%]; Hispanic participants, 38% less [95% CI, 19%–52%]). Greater LA total emptying fraction was associated with fewer PACs/hour (per SD, 16% fewer PACs/hour [95% CI, 7%–25% fewer PACs/hour]). Larger LA minimum volume was associated with more PACs/hour (per SD, 7% more PACs/hour [95% CI, 2%–13% more PACs/hour]). Associations of LA volumes with runs of supraventricular tachycardia/day were similar in direction but were weaker. CONCLUSIONS: Impaired LA function and LA enlargement were associated with more PACs/hour on extended ambulatory electrocardiographic monitoring. Measurement of supraventricular ectopy may provide information about the extent of atrial myopathy.
KW - Emptying fraction
KW - Left atrium
KW - Strain
KW - Supraventricular ectopy
KW - Volume
UR - http://www.scopus.com/inward/record.url?scp=85101118684&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85101118684&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.018093
DO - 10.1161/JAHA.120.018093
M3 - Article
C2 - 33538182
AN - SCOPUS:85101118684
SN - 2047-9980
VL - 10
SP - 1
EP - 19
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 4
M1 - e018093
ER -