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. 2012 Mar;20(3):666-72.
doi: 10.1038/oby.2011.53. Epub 2011 Apr 7.

P wave indices, obesity, and the metabolic syndrome: the atherosclerosis risk in communities study

Jared W Magnani  1 , Faye L Lopez, Elsayed Z Soliman, Richard F Maclehose, Richard S Crow, Alvaro Alonso
Affiliations

P wave indices, obesity, and the metabolic syndrome: the atherosclerosis risk in communities study

Jared W Magnani et al. Obesity (Silver Spring). 2012 Mar.

Abstract

Atrial fibrillation and obesity are increasing in prevalence and are interrelated epidemics. There has been limited assessment of how obesity and the metabolic syndrome impact P wave indices, established electrocardiographic predictors of atrial fibrillation. We conducted a cross-sectional analysis to determine the association of obesity and the components of the metabolic syndrome with P wave indices in the population-based Atherosclerosis Risk in Communities (ARIC) study. Analyses were adjusted for demographic, anthropometric and clinical variables, and cardiovascular diseases and risk factors. Following relevant exclusions, 14,433 subjects were included (55% women and 24.7% black). In multivariable analyses, we identified significant, progressive increases in PR interval, P wave maximum duration, and P wave terminal force with BMI 25-30 kg/m(2) and BMI ≥30 kg/m(2) compared to the reference group <25 kg/m(2) (P < 0.0001 for trend for all P wave indices). These effects were present in both blacks and whites. Presence of metabolic syndrome was also associated with longer P wave indices. When components of the metabolic syndrome were examined separately, hypertension resulted in significant (P < 0.001) augmentation of the three P wave indices. Similarly, waist circumference was associated with greater P wave maximum duration in both races (P < 0.001). We concluded that P wave indices are significantly associated with obesity and particularly with hypertension and waist circumference. P wave indices may comprise intermediate markers, independent of age and cardiovascular risk, of the pathway linking obesity and with the risk of atrial fibrillation (AF).

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Figures

Figure 1
Figure 1
Cubic restricted splines depicting the association of PR interval and body mass index in blacks (shown in black) and whites (shown in red) in the Atherosclerosis Risk in Communities Study. Dotted lines represent 95% confidence intervals surrounding the estimate.
Figure 2
Figure 2
Cubic restricted splines depicting the association of P wave maximum duration and body mass index in blacks (shown in black) and whites (shown in red) in the Atherosclerosis Risk in Communities Study. Dotted lines represent 95% confidence intervals surrounding the estimate.
Figure 3
Figure 3
Mean PR interval (ms), stratified by race, according to progressive increases in number of metabolic syndrome components.
Figure 4
Figure 4
Mean P wave duration (ms), stratified by race, according to progressive increases in number of metabolic syndrome components.
See this image and copyright information in PMC

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