Association between excessive supraventricular ectopy and subclinical cerebrovascular disease: a population-based study

被引：11

作者：

Hisamatsu, T. ^{[1
]}

Miura, K. ^{[2
,3
,4
]}

Fujiyoshi, A. ^{[3
]}

Kunimura, A. ^{[3
]}

Ito, T. ^{[3
]}

Miyazawa, I. ^{[3
]}

Torii, S. ^{[3
]}

Shiino, A. ^{[5
]}

Nozaki, K. ^{[4
,6
]}

Kanda, H. ^{[2
]}

Arima, H. ^{[7
]}

Ohkubo, T. ^{[8
]}

Ueshima, H. ^{[3
,4
]}

机构：

[1] Northwestern Univ, Dept Prevent Med, Feinberg Sch Med, 680 North Lake Shore Dr,Suite 1400, Chicago, IL 60611 USA

[2] Shimane Univ, Dept Environm Med & Publ Hlth, Fac Med, Izumo, Shimane, Japan

[3] Shiga Univ Med Sci, Dept Publ Hlth, Otsu, Shiga, Japan

[4] Shiga Univ Med Sci, Ctr Epidemiol Res Asia, Otsu, Shiga, Japan

[5] Shiga Univ Med Sci, Mol Neurosci Res Ctr, Otsu, Shiga, Japan

[6] Shiga Univ Med Sci, Dept Neurosurg, Otsu, Shiga, Japan

[7] Fukuoka Univ, Dept Prevent Med & Publ Hlth, Fac Med, Fukuoka, Fukuoka, Japan

[8] Teikyo Univ, Sch Med, Dept Hyg & Publ Hlth, Tokyo, Japan

来源：

EUROPEAN JOURNAL OF NEUROLOGY | 2019年 / 26卷 / 09期

基金：

日本学术振兴会; 美国国家卫生研究院;

关键词：

atrial cardiomyopathy; electrocardiography; epidemiology; magnetic resonance imaging; premature atrial contraction; subclinical cerebrovascular disease; stroke; ATRIAL-FIBRILLATION; ATHEROSCLEROSIS RISK; GENERAL-POPULATION; ISCHEMIC-STROKE; PATHOGENESIS; LESIONS;

D O I：

10.1111/ene.13970

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and purpose The association between an increased supraventricular ectopic beat (SVEB) and subclinical cerebrovascular disease remains unclear. Given the emerging concept that an increased SVEB is a marker of atrial cardiomyopathy or atherosclerosis burden, we sought to determine whether excessive supraventricular ectopic activity (ESVEA) is associated with a higher burden of subclinical cerebrovascular disease in the middle-aged to older cohort with neither apparent stroke nor atrial fibrillation. Methods We conducted a cross-sectional population-based study of 462 men (mean age, 68.1 years) who underwent 24-h Holter electrocardiography and brain magnetic resonance imaging. ESVEA was defined as the presence of >10 SVEBs/h. Subclinical cerebrovascular diseases were defined as silent brain infarct (SBI), white matter hyperintensity (WMH) and intracranial atherosclerotic stenosis (ICAS). The association of ESVEA with the presence of subclinical cerebrovascular diseases was adjusted for potential confounding covariates. Results A total of 88 (19.0%) participants had ESVEA and 81 (17.5%), 91 (19.7%) and 109 (23.6%) had SBI, WMH and ICAS, respectively. In multivariable-adjusted Poisson regression with robust error variance, ESVEA was associated with the presence of WMH (relative risk, 1.58; 95% confidence interval, 1.06-2.36) and ICAS (relative risk, 1.49; 95% confidence interval, 1.02-2.18), but not with that of SBI (relative risk, 1.32; 95% confidence interval, 0.86-2.01). These associations were consistent when the graded distributions of subclinical cerebrovascular diseases were applied as outcomes in ordinal logistic regression. Conclusions The ESVEA was independently associated with higher burdens of WMH and ICAS. This suggests that increased SVEBs might improve risk stratification of individuals at high risk of subclinical cerebrovascular disease and consequently apparent ischaemic stroke.

引用

页码：1219 / 1225

页数：7

共 27 条

[21] Atrial fibrillation is associated with anterior predominant white matter lesions in patients presenting with embolic stroke [J].