Right Ventricular Structure and Function Are Associated With Incident Atrial Fibrillation MESA-RV Study (Multi-Ethnic Study of Atherosclerosis-Right Ventricle)

被引:19
作者
Chatterjee, Neal A. [2 ]
Shah, Ravi V. [2 ]
Murthy, Venkatesh L. [3 ]
Praestgaard, Amy [4 ]
Shah, Sanjiv J. [7 ]
Ventetuolo, Corey E. [8 ]
Barr, R. Graham [9 ]
Kronmal, Richard [10 ]
Lima, Joao A. C. [11 ]
Bluemke, David A. [12 ,13 ]
Jerosch-Herold, Michael [1 ]
Alonso, Alvaro [14 ]
Kawut, Steven M. [4 ,5 ,6 ]
机构
[1] Brigham & Womens Hosp, Div Radiol, 75 Francis St, Boston, MA 02115 USA
[2] Massachusetts Gen Hosp, Dept Med, Div Cardiol, Boston, MA 02114 USA
[3] Univ Michigan, Dept Radiol, Div Nucl Med & Mol Imaging, Ann Arbor, MI 48109 USA
[4] Univ Penn, Perelman Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA
[5] Univ Penn, Perelman Sch Med, Penn Cardiovasc Inst, Philadelphia, PA 19104 USA
[6] Univ Penn, Perelman Sch Med, Pulm Allergy & Crit Care Div, Dept Med, Philadelphia, PA 19104 USA
[7] Northwestern Univ, Feinberg Sch Med, Dept Med, Div Cardiol, Chicago, IL 60611 USA
[8] Brown Univ, Alpert Med Sch, Dept Med & Hlth Serv Policy & Practice, Providence, RI 02912 USA
[9] Columbia Univ, Coll Phys & Surg, Dept Med, New York, NY USA
[10] Univ Washington, Dept Biostat, Seattle, WA 98195 USA
[11] Johns Hopkins Univ, Sch Med, Dept Med, Div Cardiol, Baltimore, MD 21205 USA
[12] Natl Inst Biomed Imaging & Bioengn, Radiol & Imaging Sci, NIH, Ctr Clin, Bethesda, MD USA
[13] Natl Inst Biomed Imaging & Bioengn, Bethesda, MD USA
[14] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA
基金
美国国家卫生研究院;
关键词
atrial fibrillation; heart failure; heart ventricles; magnetic resonance imaging; PRESERVED EJECTION FRACTION; C-REACTIVE PROTEIN; HEART-FAILURE; SEX-HORMONES; RISK-FACTORS; SLEEP-APNEA; PREVALENCE; HYPERTROPHY; MECHANISMS; PREDICTION;
D O I
10.1161/CIRCEP.116.004738
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Right ventricular (RV) morphology has been associated with drivers of atrial fibrillation (AF) risk, including left ventricular and pulmonary pathology, systemic inflammation, and neurohormonal activation. The aim of this study was to investigate the association between RV morphology and risk of incident AF. Methods and Results-We interpreted cardiac magnetic resonance imaging in 4204 participants free of clinical cardiovascular disease in the MESA (Multi-Ethnic Study of Atherosclerosis). Incident AF was determined using hospital discharge records, study electrocardiograms, and Medicare claims data. The study sample (n=3819) was 61 +/- 10 years old and 47% male with 47.2% current/former smokers. After adjustment for demographics and clinical factors, including incident heart failure, higher RV ejection fraction (hazard ratio, 1.16 per SD; 95% confidence interval, 1.03-1.32; P=0.02) and greater RV mass (hazard ratio, 1.25 per SD; 95% confidence interval, 1.08-1.44; P=0.002) were significantly associated with incident AF. After additional adjustment for the respective left ventricular parameter, higher RV ejection fraction remained significantly associated with incident AF (hazard ratio, 1.15 per SD; 95% confidence interval, 1.01-1.32; P=0.04), whereas the association was attenuated for RV mass (hazard ratio, 1.16 per SD; 95% confidence interval, 0.99-1.35; P=0.07). In a subset of patients with available spirometry (n=2540), higher RV ejection fraction and mass remained significantly associated with incident AF after additional adjustment for lung function (P=0.02 for both). Conclusions-Higher RV ejection fraction and greater RV mass were associated with an increased risk of AF in a multiethnic population free of clinical cardiovascular disease at baseline.
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页数:9
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