Markers of Atrial Myopathy in the General Population : Prevalence, Predictors, and Inter-Relations
(2023) In JACC: Clinical Electrophysiology 9(11). p.2240-2249- Abstract
BACKGROUND: Atrial myopathy refers to structural and functional cardiac abnormalities associated with atrial fibrillation and stroke, but appropriate diagnostic criteria are lacking.
OBJECTIVES: This study aimed to assess prevalence, clinical correlates, and overlap between potential atrial myopathy markers.
METHODS: The population-based SCAPIS (Swedish CArdioPulmonary bioImage Study) prospectively included 6,013 subjects without atrial fibrillation with 24-hour electrocardiograms. Resting electrocardiograms measuring P-wave indices were collected at 1 screening site (n = 1,201), and a random sample (n = 385) had echocardiographic left atrial volume index (LAVi). Atrial myopathy markers were defined as ≥500 premature atrial... (More)
BACKGROUND: Atrial myopathy refers to structural and functional cardiac abnormalities associated with atrial fibrillation and stroke, but appropriate diagnostic criteria are lacking.
OBJECTIVES: This study aimed to assess prevalence, clinical correlates, and overlap between potential atrial myopathy markers.
METHODS: The population-based SCAPIS (Swedish CArdioPulmonary bioImage Study) prospectively included 6,013 subjects without atrial fibrillation with 24-hour electrocardiograms. Resting electrocardiograms measuring P-wave indices were collected at 1 screening site (n = 1,201), and a random sample (n = 385) had echocardiographic left atrial volume index (LAVi). Atrial myopathy markers were defined as ≥500 premature atrial complexes/24 h, LAVi ≥34 mL/m2, P-wave duration >120 milliseconds, or P-wave terminal force in V1 >4,000 ms·s. Clinical correlates included age, sex, body mass index, height, smoking, physical activity, coronary artery disease, diabetes, systolic blood pressure, antihypertensive medication, and low education.
RESULTS: Atrial myopathy was common; 42% of the sample with all diagnostic modalities available had ≥1 atrial myopathy marker, but only 9% had 2 and 0.3% had ≥3. Only P-wave duration and LAVi were correlated (ρ = 0.10; P = 0.04). Clinical correlates of premature atrial complexes, P-wave indices, and LAVi differed; current smoking (34% increase; P < 0.001), systolic blood pressure (4%/mm Hg increase; P = 0.01), diabetes (35% increase; P = 0.001), and coronary artery disease (71% increase; P = 0.003) were associated with premature atrial complexes, physical activity ≥2 h/wk was associated with increased LAVi (β-coefficient = 3.1; P < 0.0001) and body mass index was associated with P-wave duration (β-coefficient = 0.4/kg/m2; P < 0.0001).
CONCLUSIONS: In the general population, indirect markers of atrial myopathy are common but only weakly correlated, and their risk factor patterns are different. More studies are needed to accurately identify individuals with atrial myopathy with diagnostic methods.
(Less)
- author
- Johnson, Linda S LU ; Platonov, Pyotr G LU ; Conen, David ; Kennbäck, Cecilia LU ; Jujic, Amra LU ; Healey, Jeffrey S ; Holm, Hannes LU ; Sundström, Johan and Engström, Gunnar LU
- organization
-
- Cardiovascular Research - Epidemiology (research group)
- EpiHealth: Epidemiology for Health
- Electrocardiology Research Group - CIEL (research group)
- Cardiology
- Internal Medicine - Epidemiology (research group)
- EXODIAB: Excellence of Diabetes Research in Sweden
- Cardiovascular Research - Hypertension (research group)
- publishing date
- 2023-08-25
- type
- Contribution to journal
- publication status
- published
- subject
- in
- JACC: Clinical Electrophysiology
- volume
- 9
- issue
- 11
- pages
- 2240 - 2249
- publisher
- Elsevier
- external identifiers
-
- scopus:85172259668
- pmid:37676201
- ISSN
- 2405-5018
- DOI
- 10.1016/j.jacep.2023.07.012
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
- id
- faf49400-54ae-4127-9159-e1defd5a81a9
- date added to LUP
- 2023-09-21 13:49:18
- date last changed
- 2024-04-19 01:14:27
@article{faf49400-54ae-4127-9159-e1defd5a81a9,
abstract = {{<p>BACKGROUND: Atrial myopathy refers to structural and functional cardiac abnormalities associated with atrial fibrillation and stroke, but appropriate diagnostic criteria are lacking.</p><p>OBJECTIVES: This study aimed to assess prevalence, clinical correlates, and overlap between potential atrial myopathy markers.</p><p>METHODS: The population-based SCAPIS (Swedish CArdioPulmonary bioImage Study) prospectively included 6,013 subjects without atrial fibrillation with 24-hour electrocardiograms. Resting electrocardiograms measuring P-wave indices were collected at 1 screening site (n = 1,201), and a random sample (n = 385) had echocardiographic left atrial volume index (LAVi). Atrial myopathy markers were defined as ≥500 premature atrial complexes/24 h, LAVi ≥34 mL/m2, P-wave duration >120 milliseconds, or P-wave terminal force in V1 >4,000 ms·s. Clinical correlates included age, sex, body mass index, height, smoking, physical activity, coronary artery disease, diabetes, systolic blood pressure, antihypertensive medication, and low education.</p><p>RESULTS: Atrial myopathy was common; 42% of the sample with all diagnostic modalities available had ≥1 atrial myopathy marker, but only 9% had 2 and 0.3% had ≥3. Only P-wave duration and LAVi were correlated (ρ = 0.10; P = 0.04). Clinical correlates of premature atrial complexes, P-wave indices, and LAVi differed; current smoking (34% increase; P < 0.001), systolic blood pressure (4%/mm Hg increase; P = 0.01), diabetes (35% increase; P = 0.001), and coronary artery disease (71% increase; P = 0.003) were associated with premature atrial complexes, physical activity ≥2 h/wk was associated with increased LAVi (β-coefficient = 3.1; P < 0.0001) and body mass index was associated with P-wave duration (β-coefficient = 0.4/kg/m2; P < 0.0001).</p><p>CONCLUSIONS: In the general population, indirect markers of atrial myopathy are common but only weakly correlated, and their risk factor patterns are different. More studies are needed to accurately identify individuals with atrial myopathy with diagnostic methods.</p>}},
author = {{Johnson, Linda S and Platonov, Pyotr G and Conen, David and Kennbäck, Cecilia and Jujic, Amra and Healey, Jeffrey S and Holm, Hannes and Sundström, Johan and Engström, Gunnar}},
issn = {{2405-5018}},
language = {{eng}},
month = {{08}},
number = {{11}},
pages = {{2240--2249}},
publisher = {{Elsevier}},
series = {{JACC: Clinical Electrophysiology}},
title = {{Markers of Atrial Myopathy in the General Population : Prevalence, Predictors, and Inter-Relations}},
url = {{http://dx.doi.org/10.1016/j.jacep.2023.07.012}},
doi = {{10.1016/j.jacep.2023.07.012}},
volume = {{9}},
year = {{2023}},
}