Associations of left atrial function and structure with supraventricular ectopy: The multi-ethnic study of atherosclerosis

Susan R. Heckbert, Paul N. Jensen, Thomas R. Austin, Lin Yee Chen, Wendy S. Post, Bharath Ambale Venkatesh, Elsayed Z. Soliman, James S. Floyd, Nona Sotoodehnia, Richard A. Kronmal, Joao A.C. Lima

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Article numbere018093
Pages (from-to)1-19
Number of pages19
JournalJournal of the American Heart Association
Volume10
Issue number4
DOIs
StatePublished - Feb 16 2021

Bibliographical note

Funding Information:
This work was supported by National Institutes of Health (NIH) contracts 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 and grants R01 HL127659, UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420. The research reported herein is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funding agencies had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Publisher Copyright:
© 2021 The Authors.

Keywords

  • Emptying fraction
  • Left atrium
  • Strain
  • Supraventricular ectopy
  • Volume

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