Association of Right Ventricular Afterload With Atrial Fibrillation Risk in Older Adults: The Atherosclerosis Risk in Communities Study.

Aged Female Humans Male Antihypertensive Agents Atherosclerosis Atrial Fibrillation / complications Prospective Studies Tricuspid Valve Insufficiency Ventricular Remodeling
aging atrial fibrillation pulmonary circulation pulmonary hypertension right ventricle

Journal

Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335

Informations de publication

Date de publication:
10 2022
Historique:
received: 10 11 2021
revised: 03 05 2022
accepted: 04 05 2022
pubmed: 14 5 2022
medline: 12 10 2022
entrez: 13 5 2022
Statut: ppublish

Résumé

Atrial fibrillation (AF) is widely perceived to originate from the left atrium (LA). Whether increases in right ventricular (RV) afterload in older adults play an etiological role in AF genesis independent of LA and left ventricular (LV) remodeling is unknown. Is higher RV afterload associated with greater AF risk independent of LA and LV remodeling? In this observational prospective study, we included 2,246 community-dwelling older adults (mean age, 75 years) without known cardiovascular disease, with LV ejection fraction > 50%, LA volume index < 34 mL/m During follow-up (median, 6.3 years; interquartile interval, 5.5-6.9 years), 215 participants developed AF. AF risk was significantly higher in the third (vs first) tertile of PASP (HR, 1.65; 95% CI, 1.08-2.54) and PVR (HR, 1.38; 95% CI, 1.00-2.08) independent of LA and LV structure and function, heart rate, BMI, prevalent sleep apnea, systemic BP, antihypertensive medications, and lung, kidney, and thyroid function. These associations persisted after further exclusion of participants with tricuspid regurgitation jet velocity > 2.8 m/s and lateral and septal mitral annular velocity above age- and sex-specific reference limits. In older adults, higher RV afterload is associated with greater AF risk independent of LA and LV remodeling. Future research should focus on confirming this novel association and elucidate underlying mechanisms.

Sections du résumé

BACKGROUND
Atrial fibrillation (AF) is widely perceived to originate from the left atrium (LA). Whether increases in right ventricular (RV) afterload in older adults play an etiological role in AF genesis independent of LA and left ventricular (LV) remodeling is unknown.
RESEARCH QUESTION
Is higher RV afterload associated with greater AF risk independent of LA and LV remodeling?
STUDY DESIGN AND METHODS
In this observational prospective study, we included 2,246 community-dwelling older adults (mean age, 75 years) without known cardiovascular disease, with LV ejection fraction > 50%, LA volume index < 34 mL/m
RESULTS
During follow-up (median, 6.3 years; interquartile interval, 5.5-6.9 years), 215 participants developed AF. AF risk was significantly higher in the third (vs first) tertile of PASP (HR, 1.65; 95% CI, 1.08-2.54) and PVR (HR, 1.38; 95% CI, 1.00-2.08) independent of LA and LV structure and function, heart rate, BMI, prevalent sleep apnea, systemic BP, antihypertensive medications, and lung, kidney, and thyroid function. These associations persisted after further exclusion of participants with tricuspid regurgitation jet velocity > 2.8 m/s and lateral and septal mitral annular velocity above age- and sex-specific reference limits.
INTERPRETATION
In older adults, higher RV afterload is associated with greater AF risk independent of LA and LV remodeling. Future research should focus on confirming this novel association and elucidate underlying mechanisms.

Identifiants

DOI: 10.1016/j.chest.2022.05.004 PMID: 35562059 PMC: PMC9659616
pubmed: 35562059
pii: S0012-3692(22)00899-6
doi: 10.1016/j.chest.2022.05.004
pmc: PMC9659616
pii:
doi:

Substances chimiques

Antihypertensive Agents 0

Types de publication

Journal Article Observational Study Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

884-893

Subventions

Organisme : NHLBI NIH HHS
ID : R01 HL162927
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL158022
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24 HL155813
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700002C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700001I
Pays : United States
Organisme : NHLBI NIH HHS
ID : K08 HL140100
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL158795
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700003I
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL126637
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004I
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24 HL152008
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700005C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700001C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700003C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004C
Pays : United States
Organisme : NINDS NIH HHS
ID : RF1 NS127266
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL141288
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700002I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700005I
Pays : United States

Informations de copyright

Published by Elsevier Inc.

Références

J Am Soc Echocardiogr. 2020 Nov;33(11):1334-1344.e2
pubmed: 32747222
Eur Heart J Cardiovasc Imaging. 2015 Sep;16(9):1031-41
pubmed: 25896355
J Cardiovasc Electrophysiol. 1999 Mar;10(3):328-35
pubmed: 10210494
J Am Soc Echocardiogr. 2013 Oct;26(10):1170-1177
pubmed: 23860092
Pulm Circ. 2020 Mar 9;10(1):2045894020910685
pubmed: 32215200
Circulation. 2017 Jan 31;135(5):426-439
pubmed: 27927714
J Am Coll Cardiol. 2021 Jun 15;77(23):2939-2959
pubmed: 34112321
Circulation. 2020 Mar 3;141(9):e139-e596
pubmed: 31992061
Circ Arrhythm Electrophysiol. 2008 Apr;1(1):6-13
pubmed: 19808388
Int J Stroke. 2021 Feb;16(2):217-221
pubmed: 31955707
J Am Coll Cardiol. 2018 May 8;71(18):2041-2057
pubmed: 29724357
Circ Cardiovasc Imaging. 2011 Sep;4(5):524-31
pubmed: 21778328
Circulation. 2005 Sep 20;112(12):1692-700
pubmed: 16157775
J Am Coll Cardiol. 2004 Jul 7;44(1):109-16
pubmed: 15234418
Stat Methods Med Res. 2013 Jun;22(3):278-95
pubmed: 21220355
Eur Respir J. 2015 Mar;45(3):807-27
pubmed: 25657021
Circulation. 2009 May 26;119(20):2663-70
pubmed: 19433755
Stat Med. 2011 Feb 20;30(4):377-99
pubmed: 21225900
J Am Soc Echocardiogr. 2016 Apr;29(4):277-314
pubmed: 27037982
Circ Cardiovasc Imaging. 2015 Nov;8(11):e003521; discussion e003521
pubmed: 26514759
J Am Coll Cardiol. 2006 Mar 7;47(5):1018-23
pubmed: 16516087
PLoS Med. 2020 Oct 15;17(10):e1003361
pubmed: 33057391
Eur Respir J. 2019 Jan 24;53(1):
pubmed: 30545968
Eur Respir J. 2003 Jun;21(6):1012-6
pubmed: 12797497
J Atr Fibrillation. 2014 Apr 30;6(6):1085
pubmed: 27957069
Eur Heart J. 2016 Jan 1;37(1):67-119
pubmed: 26320113
Cureus. 2021 Apr 20;13(4):e14575
pubmed: 34035997
Circulation. 2014 Mar 4;129(9):971-80
pubmed: 24344084
Am J Cardiol. 2013 Sep 15;112(6):873-82
pubmed: 23735649
J Am Soc Echocardiogr. 2020 Oct;33(10):1223-1233
pubmed: 32741597
J Appl Physiol. 1967 Nov;23(5):631-40
pubmed: 6061377
Thorax. 1978 Jun;33(3):335-44
pubmed: 684670
J Am Soc Echocardiogr. 2020 Aug;33(8):1006-1013
pubmed: 32336608
J Thorac Dis. 2018 May;10(5):2789-2794
pubmed: 29997941
Circ Arrhythm Electrophysiol. 2011 Dec;4(6):815-22
pubmed: 21946388
Europace. 2013 Dec;15(12):1777-83
pubmed: 23787904
J Cardiovasc Magn Reson. 2020 May 21;22(1):36
pubmed: 32434529
Circulation. 2018 Aug 28;138(9):861-870
pubmed: 29792299
Am Heart J. 2009 Jul;158(1):111-7
pubmed: 19540400
Circ Cardiovasc Imaging. 2014 Jan;7(1):173-81
pubmed: 24214885
Arrhythm Electrophysiol Rev. 2018 Mar;7(1):43-48
pubmed: 29636972

Auteurs

Romil R Parikh (RR)

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN; Lillehei Heart Institute and Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.

Faye L Norby (FL)

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN; Center for Cardiac Arrest Prevention, Department of Cardiology, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA.

Wendy Wang (W)

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN; Lillehei Heart Institute and Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.

Thenappan Thenappan (T)

Lillehei Heart Institute and Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.

Kurt W Prins (KW)

Lillehei Heart Institute and Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.

Jeremy R Van't Hof (JR)

Lillehei Heart Institute and Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.

Pamela L Lutsey (PL)

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.

Scott D Solomon (SD)

Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA.

Amil M Shah (AM)

Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA.

Lin Yee Chen (LY)

Lillehei Heart Institute and Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN. Electronic address: chenx484@umn.edu.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Association of Right Ventricular Afterload...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Association of Right Ventricular Afterload...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents cardiovasculaires › Antihypertenseurs › Association of Right Ventricular Afterload...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Artériopathies oblitérantes › Artériosclérose › Athérosclérose › Association of Right Ventricular Afterload...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Fibrillation auriculaire › Association of Right Ventricular Afterload...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Association of Right Ventricular Afterload...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Valvulopathies › Insuffisance tricuspide › Association of Right Ventricular Afterload...
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiologiques cardiovasculaires › Fonction ventriculaire › Remodelage ventriculaire › Association of Right Ventricular Afterload...