Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study
Background Black Americans have more atrial fibrillation risk factors but lower atrial fibrillation risk than White Americans. Left atrial (LA) enlargement and/or dysfunction, frequent atrial tachycardia (AT), and premature atrial contractions (PAC) are associated with increased atrial fibrillation...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-11-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.021723 |
| _version_ | 1797884394046750720 |
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| author | Wendy Wang Faye L. Norby Michael J. Zhang Jorge L. Reyes Amil M. Shah Elsayed Z. Soliman Pamela L. Lutsey Alvaro Alonso Scott D. Solomon Riccardo M. Inciardi Lin Y. Chen |
| author_facet | Wendy Wang Faye L. Norby Michael J. Zhang Jorge L. Reyes Amil M. Shah Elsayed Z. Soliman Pamela L. Lutsey Alvaro Alonso Scott D. Solomon Riccardo M. Inciardi Lin Y. Chen |
| author_sort | Wendy Wang |
| collection | DOAJ |
| description | Background Black Americans have more atrial fibrillation risk factors but lower atrial fibrillation risk than White Americans. Left atrial (LA) enlargement and/or dysfunction, frequent atrial tachycardia (AT), and premature atrial contractions (PAC) are associated with increased atrial fibrillation risk. Racial differences in these factors may exist that could explain the difference in atrial fibrillation risk. Methods and Results We included 2133 ARIC (Atherosclerosis Risk in Communities) study participants (aged 74±4.5 years[mean±SD], 59% women, 27% Black participants) who had echocardiograms in 2011 to 2013 and wore the Zio XT Patch (a 2‐week continuous heart monitor) in 2016 to 2017. Linear regression was used to analyze (1) differences in AT/day or PAC/hour between Black and White participants, (2) differences in LA measures between Black and White participants, and (3) racial differences in the association of LA measures with AT or PAC frequency. Compared with White participants, Black participants had a higher prevalence of cardiovascular risk factors and disease, lower AT frequency, greater LA size, and lower LA function. After multivariable adjustments, Black participants had 37% (95% CI, 24%–47%) fewer AT runs/day than White participants. No difference in PAC between races was noted. Greater LA size and reduced LA function are associated with more AT and PAC runs; however, no race interaction was present. Conclusions Differences in LA measures are unlikely to explain the difference in atrial fibrillation risk between Black and White individuals. Despite more cardiovascular risk factors and greater atrial remodeling, Black participants have lower AT frequency than White participants. Future research is needed to elucidate the protective mechanisms that confer resilience to atrial arrhythmias in Black individuals. |
| first_indexed | 2024-04-10T04:06:30Z |
| format | Article |
| id | doaj.art-28d9ee63a74b415182fb6007763d7528 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T04:06:30Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-28d9ee63a74b415182fb6007763d75282023-03-13T05:24:49ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-11-01102110.1161/JAHA.121.021723Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC StudyWendy Wang0Faye L. Norby1Michael J. Zhang2Jorge L. Reyes3Amil M. Shah4Elsayed Z. Soliman5Pamela L. Lutsey6Alvaro Alonso7Scott D. Solomon8Riccardo M. Inciardi9Lin Y. Chen10Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MNCenter for Cardiac Arrest Prevention Department of Cardiology Cedars‐Sinai Smidt Heart Institute Los Angeles CACardiovascular Division Department of Medicine University of Minnesota Medical School Minneapolis MNDepartment of Medicine Hennepin County Medical Center Minneapolis MNCardiovascular Division Brigham and Women’s Hospital Boston MADepartment of Epidemiology Division of Public Health Sciences Wake Forest University School of Medicine Winston‐Salem NCDivision of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MNDepartment of Epidemiology Rollins School of Public Health Emory University Atlanta GACardiovascular Division Brigham and Women’s Hospital Boston MAInstitute of Cardiology Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia ItalyCardiovascular Division Department of Medicine University of Minnesota Medical School Minneapolis MNBackground Black Americans have more atrial fibrillation risk factors but lower atrial fibrillation risk than White Americans. Left atrial (LA) enlargement and/or dysfunction, frequent atrial tachycardia (AT), and premature atrial contractions (PAC) are associated with increased atrial fibrillation risk. Racial differences in these factors may exist that could explain the difference in atrial fibrillation risk. Methods and Results We included 2133 ARIC (Atherosclerosis Risk in Communities) study participants (aged 74±4.5 years[mean±SD], 59% women, 27% Black participants) who had echocardiograms in 2011 to 2013 and wore the Zio XT Patch (a 2‐week continuous heart monitor) in 2016 to 2017. Linear regression was used to analyze (1) differences in AT/day or PAC/hour between Black and White participants, (2) differences in LA measures between Black and White participants, and (3) racial differences in the association of LA measures with AT or PAC frequency. Compared with White participants, Black participants had a higher prevalence of cardiovascular risk factors and disease, lower AT frequency, greater LA size, and lower LA function. After multivariable adjustments, Black participants had 37% (95% CI, 24%–47%) fewer AT runs/day than White participants. No difference in PAC between races was noted. Greater LA size and reduced LA function are associated with more AT and PAC runs; however, no race interaction was present. Conclusions Differences in LA measures are unlikely to explain the difference in atrial fibrillation risk between Black and White individuals. Despite more cardiovascular risk factors and greater atrial remodeling, Black participants have lower AT frequency than White participants. Future research is needed to elucidate the protective mechanisms that confer resilience to atrial arrhythmias in Black individuals.https://www.ahajournals.org/doi/10.1161/JAHA.121.021723arrhythmiaatrial tachycardiaechocardiogramepidemiologyrace and ethnicity |
| spellingShingle | Wendy Wang Faye L. Norby Michael J. Zhang Jorge L. Reyes Amil M. Shah Elsayed Z. Soliman Pamela L. Lutsey Alvaro Alonso Scott D. Solomon Riccardo M. Inciardi Lin Y. Chen Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease arrhythmia atrial tachycardia echocardiogram epidemiology race and ethnicity |
| title | Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study |
| title_full | Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study |
| title_fullStr | Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study |
| title_full_unstemmed | Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study |
| title_short | Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study |
| title_sort | differences in left atrial size and function and supraventricular ectopy between black and white participants in the aric study |
| topic | arrhythmia atrial tachycardia echocardiogram epidemiology race and ethnicity |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.021723 |
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