Pulse lineResearch With Heart Logo

Associations of Left Atrial Function and Structure With Supraventricular Ectopy: The Multi-Ethnic Study of Atherosclerosis.

TitleAssociations of Left Atrial Function and Structure With Supraventricular Ectopy: The Multi-Ethnic Study of Atherosclerosis.
Publication TypeJournal Article
Year of Publication2021
AuthorsHeckbert SR, Jensen PN, Austin TR, Chen LYee, Post WS, Venkatesh BAmbale, Soliman EZ, Floyd JS, Sotoodehnia N, Kronmal RA, Lima JAC
JournalJ Am Heart Assoc
Volume10
Issue4
Paginatione018093
Date Published2021 02 16
ISSN2047-9980
KeywordsAged, Aged, 80 and over, Atherosclerosis, Atrial Function, Left, Electrocardiography, Ambulatory, Ethnicity, Female, Heart Atria, Humans, Incidence, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Risk Factors, Tachycardia, Ectopic Atrial, United States
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.

DOI10.1161/JAHA.120.018093
Alternate JournalJ Am Heart Assoc
PubMed ID33538182
PubMed Central IDPMC7955336
Grant ListN01 HC095163 / HC / NHLBI NIH HHS / United States
N01 HC095168 / HC / NHLBI NIH HHS / United States
N01 HC095162 / HC / NHLBI NIH HHS / United States
UL1 TR001420 / TR / NCATS NIH HHS / United States
N01 HC095169 / HC / NHLBI NIH HHS / United States
N01 HC095159 / HC / NHLBI NIH HHS / United States
N01 HC095161 / HC / NHLBI NIH HHS / United States
HHSN268201500003I / HL / NHLBI NIH HHS / United States
N01 HC095166 / HC / NHLBI NIH HHS / United States
UL1 TR001079 / TR / NCATS NIH HHS / United States
UL1 TR000040 / TR / NCATS NIH HHS / United States
N01 HC095167 / HC / NHLBI NIH HHS / United States
N01 HC095164 / HC / NHLBI NIH HHS / United States
R01 HL127659 / HL / NHLBI NIH HHS / United States
N01 HC095160 / HC / NHLBI NIH HHS / United States
R01 HL142599 / HL / NHLBI NIH HHS / United States
N01 HC095165 / HC / NHLBI NIH HHS / United States