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Markers of Atrial Myopathy in the General Population

医学 心脏病学 内科学 心房颤动 肌病 冠状动脉疾病 体质指数 人口 房性早搏 环境卫生
作者
Linda Johnson,Pyotr G. Platonov,David Conen,Cecilia Kennbäck,Amra Jujić,Jeffrey S. Healey,Hannes Holm,Johan Sundström,Gunnar Engström
出处
期刊:JACC: Clinical Electrophysiology [Elsevier BV]
卷期号:9 (11): 2240-2249 被引量:1
标识
DOI:10.1016/j.jacep.2023.07.012
摘要

Atrial myopathy refers to structural and functional cardiac abnormalities associated with atrial fibrillation and stroke, but appropriate diagnostic criteria are lacking.This study aimed to assess prevalence, clinical correlates, and overlap between potential atrial myopathy markers.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.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).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.
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