Multicenter Study

. 2014 May 20;63(19):2007-13.

doi: 10.1016/j.jacc.2014.01.066. Epub 2014 Mar 19.

Association of electrocardiographic and imaging surrogates of left ventricular hypertrophy with incident atrial fibrillation: MESA (Multi-Ethnic Study of Atherosclerosis)

Jonathan Chrispin¹, Aditya Jain², Elsayed Z Soliman³, Eliseo Guallar⁴, Alvaro Alonso⁵, Susan R Heckbert⁶, David A Bluemke⁷, João A C Lima², Saman Nazarian⁸

Affiliations

¹ Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: chrispin@jhmi.edu.
² Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
³ Departments of Epidemiology and Prevention and Internal Medicine, Cardiology Section, Epidemiological Cardiology Research Center (EPICARE), Wake Forest University School of Medicine, Winston-Salem, North Carolina.
⁴ Welch Center for Prevention, Epidemiology and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
⁵ Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
⁶ Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington.
⁷ Radiology and Imaging Sciences, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health Clinical Center and National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland.
⁸ Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Welch Center for Prevention, Epidemiology and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

PMID: 24657688
PMCID: PMC4024364
DOI: 10.1016/j.jacc.2014.01.066

Multicenter Study

Association of electrocardiographic and imaging surrogates of left ventricular hypertrophy with incident atrial fibrillation: MESA (Multi-Ethnic Study of Atherosclerosis)

Jonathan Chrispin et al. J Am Coll Cardiol. 2014.

. 2014 May 20;63(19):2007-13.

doi: 10.1016/j.jacc.2014.01.066. Epub 2014 Mar 19.

Authors

Jonathan Chrispin¹, Aditya Jain², Elsayed Z Soliman³, Eliseo Guallar⁴, Alvaro Alonso⁵, Susan R Heckbert⁶, David A Bluemke⁷, João A C Lima², Saman Nazarian⁸

Affiliations

¹ Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: chrispin@jhmi.edu.
² Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
³ Departments of Epidemiology and Prevention and Internal Medicine, Cardiology Section, Epidemiological Cardiology Research Center (EPICARE), Wake Forest University School of Medicine, Winston-Salem, North Carolina.
⁴ Welch Center for Prevention, Epidemiology and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
⁵ Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
⁶ Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington.
⁷ Radiology and Imaging Sciences, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health Clinical Center and National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland.
⁸ Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Welch Center for Prevention, Epidemiology and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

PMID: 24657688
PMCID: PMC4024364
DOI: 10.1016/j.jacc.2014.01.066

Abstract

Objectives: This study sought to examine the association between left ventricular hypertrophy (LVH), deﬁned by cardiac magnetic resonance (CMR) and electrocardiography (ECG), with incident atrial fibrillation (AF).

Background: Previous studies of the association between AF and LVH were based primarily on echocardiographic measures of LVH.

Methods: The MESA (Multi-Ethnic Study of Atherosclerosis) enrolled 4,942 participants free of clinically recognized cardiovascular disease. Incident AF was based on MESA-ascertained hospital-discharge International Classification of Diseases codes and Centers for Medicare and Medicaid Services inpatient hospital claims. CMR-LVH was defined as left ventricular mass ≥95th percentile of the MESA population distribution. Eleven ECG-LVH criteria were assessed. The association of LVH with incident AF was evaluated using multivariable Cox proportional hazards models adjusted for CVD risk factors.

Results: During a median follow-up of 6.9 years, 214 incident AF events were documented. Participants with AF were more likely to be older, hypertensive, and overweight. The risk of AF was greater in participants with CMR-derived LVH (hazard ratio [HR]: 2.04, 95% confidence interval [CI]: 1.15 to 3.62). AF was associated with ECG-derived LVH measure of Sokolow-Lyon voltage product after adjusting for CMR-LVH (HR: 1.83, 95% CI: 1.06 to 3.14, p = 0.02). The associations with AF for CMR-LVH and Sokolow-Lyon voltage product were attenuated when adjusted for CMR left atrial volumes.

Conclusions: In a multiethnic cohort of participants without clinically detected cardiovascular disease, both CMR and ECG-derived LVH were associated with incident AF. ECG-LVH showed prognostic signiﬁcance independent of CMR-LVH. The association was attenuated when adjusted for CMR left atrial volumes.

Keywords: atrial fibrillation; cardiac magnetic resonance imaging; electrocardiography; left ventricular hypertrophy.

PubMed Disclaimer

Conflict of interest statement

Disclosures: Dr Nazarian is a scientific advisor to and PI for research funding to Johns Hopkins University from Biosense-Webster Incorporated. The other authors declare no conflicts of interest.

Comment in

Structural and functional cardiac changes are target organ damage that increases risk of atrial fibrillation.
Wachtell K, Greve AM. Wachtell K, et al. J Am Coll Cardiol. 2014 May 20;63(19):2014-5. doi: 10.1016/j.jacc.2014.02.548. Epub 2014 Mar 19. J Am Coll Cardiol. 2014. PMID: 24657691 No abstract available.

References

1. Lewis T. Auricular Fibrillation: a common clinical condition. BMJ. 1909;2:1528. - PMC - PubMed
1. Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98:946–952. - PubMed
1. Krahn AD, Manfreda J, Tate RB, Mathewson FA, Cuddy TE. The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. Am J Med. 1995;98:476–484. - PubMed
1. Stewart S, Hart CL, Hole DJ, McMurray JJ. A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study. Am J Med. 2002;113:359–364. - PubMed
1. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, D'Agostino RB, Massaro JM, Beiser A, Wolf PA, Benjamin EJ. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004;110:1042–1046. - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Association of electrocardiographic and imaging surrogates of left ventricular hypertrophy with incident atrial fibrillation: MESA (Multi-Ethnic Study of Atherosclerosis)

Affiliations

Association of electrocardiographic and imaging surrogates of left ventricular hypertrophy with incident atrial fibrillation: MESA (Multi-Ethnic Study of Atherosclerosis)

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical