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Echocardiographic diastolic parameters and risk of atrial fibrillation: the Cardiovascular Health Study.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Echocardiographic diastolic parameters and risk of atrial fibrillation: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2012 |
| Authors | Rosenberg, MA, Gottdiener, JS, Heckbert, SR, Mukamal, KJ |
| Journal | Eur Heart J |
| Volume | 33 |
| Issue | 7 |
| Pagination | 904-12 |
| Date Published | 2012 Apr |
| ISSN | 1522-9645 |
| Keywords | Aged, Atrial Fibrillation, Blood Flow Velocity, Diastole, Echocardiography, Doppler, Female, Humans, Kaplan-Meier Estimate, Longitudinal Studies, Male, Natriuretic Peptide, Brain, Peptide Fragments, Risk Factors, United States, Ventricular Dysfunction, Left |
| Abstract | <p><b>AIMS: </b>Atrial fibrillation (AF) is the most common sustained arrhythmia in the elderly, and shares several risk factors with diastolic dysfunction, including hypertension and advanced age. The purpose of this study is to examine diastolic dysfunction as a risk for incident AF.</p><p><b>METHODS AND RESULTS: </b>We examined the association of echocardiographic parameters of diastolic function with the incidence of AF in 4480 participants enrolled in the Cardiovascular Health Study, an ongoing cohort of community-dwelling older adults from four US communities. Participants underwent baseline echocardiography in 1989-1990 and were followed for incident AF on routine follow-up and hospitalizations. After 50 941 person-years of follow-up (median follow-up time 12.1 years), 1219 participants developed AF. In multivariable-adjusted age-stratified Cox models, diastolic echocardiographic parameters were significantly associated with the risk of incident AF. The most significant parameters were the Doppler peak E-wave velocity and left atrial diameter, which demonstrated a positive nonlinear association [HR 1.5 (CI 1.3-1.9) and HR 1.7 (CI 1.4-2.1) for highest vs. lowest quintile, respectively], and Doppler A-wave velocity time integral, which displayed a U-shaped relationship with the risk of AF [HR 0.7 (CI 0.6-0.9) for middle vs. lowest quintile]. Each diastolic parameter displayed a significant association with adjusted NT-proBNP levels, although the nature of the association did not entirely parallel the risk of AF. Further cluster analysis revealed unique patterns of diastolic function that may identify patients at risk for AF.</p><p><b>CONCLUSION: </b>In a community-based population of older adults, echocardiographic measures of diastolic function are significantly associated with an increased risk of AF.</p> |
| DOI | 10.1093/eurheartj/ehr378 |
| Alternate Journal | Eur. Heart J. |
| PubMed ID | 21990265 |
| PubMed Central ID | PMC3345546 |
| Grant List | AG-15928 / AG / NIA NIH HHS / United States AG-20098 / AG / NIA NIH HHS / United States N01-HC-85079-86 / HC / NHLBI NIH HHS / United States HL068986 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01 HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-45133 / HC / NHLBI NIH HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85239 / HC / NHLBI NIH HHS / United States AG-023629 / AG / NIA NIH HHS / United States R01 HL068986 / HL / NHLBI NIH HHS / United States |