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Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study.

TitleDifferences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study.
Publication TypeJournal Article
Year of Publication2021
AuthorsWang W, Norby FL, Zhang MJ, Reyes JL, Shah AM, Soliman EZ, Lutsey PL, Alonso A, Solomon SD, Inciardi RM, Chen LY
JournalJ Am Heart Assoc
Volume10
Issue21
Paginatione021723
Date Published2021 11 02
ISSN2047-9980
KeywordsAged, Atrial Fibrillation, Atrial Premature Complexes, Blacks, Cardiomyopathies, Electrocardiography, Ambulatory, Female, Heart Atria, Humans, Male, Risk Factors, Tachycardia, Supraventricular
Abstract

Background Black Americans have more atrial fibrillation risk factors but lower atrial fibrillation risk than White Americans. Left atrial (LA) enlargement and/or dysfunction, frequent atrial tachycardia (AT), and premature atrial contractions (PAC) are associated with increased atrial fibrillation risk. Racial differences in these factors may exist that could explain the difference in atrial fibrillation risk. Methods and Results We included 2133 ARIC (Atherosclerosis Risk in Communities) study participants (aged 74±4.5 years[mean±SD], 59% women, 27% Black participants) who had echocardiograms in 2011 to 2013 and wore the Zio XT Patch (a 2-week continuous heart monitor) in 2016 to 2017. Linear regression was used to analyze (1) differences in AT/day or PAC/hour between Black and White participants, (2) differences in LA measures between Black and White participants, and (3) racial differences in the association of LA measures with AT or PAC frequency. Compared with White participants, Black participants had a higher prevalence of cardiovascular risk factors and disease, lower AT frequency, greater LA size, and lower LA function. After multivariable adjustments, Black participants had 37% (95% CI, 24%-47%) fewer AT runs/day than White participants. No difference in PAC between races was noted. Greater LA size and reduced LA function are associated with more AT and PAC runs; however, no race interaction was present. Conclusions Differences in LA measures are unlikely to explain the difference in atrial fibrillation risk between Black and White individuals. Despite more cardiovascular risk factors and greater atrial remodeling, Black participants have lower AT frequency than White participants. Future research is needed to elucidate the protective mechanisms that confer resilience to atrial arrhythmias in Black individuals.

DOI10.1161/JAHA.121.021723
Alternate JournalJ Am Heart Assoc
PubMed ID34713724
PubMed Central IDPMC8751819
Grant ListHHSN268201700001I / HL / NHLBI NIH HHS / United States
R01 HL150342 / HL / NHLBI NIH HHS / United States
K24 HL159246 / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700004C / HL / NHLBI NIH HHS / United States
R01 HL126637 / HL / NHLBI NIH HHS / United States
R01 HL135008 / HL / NHLBI NIH HHS / United States
K24 HL155813 / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
R01 HL148218 / HL / NHLBI NIH HHS / United States
K24 HL148521 / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
K24 HL152008 / HL / NHLBI NIH HHS / United States
R01 HL141288 / HL / NHLBI NIH HHS / United States
T32 GM132063 / GM / NIGMS NIH HHS / United States
R01 HL143224 / HL / NHLBI NIH HHS / United States