Electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi-ethnic study of atherosclerosis (MESA) cohort
BackgroundThe association of electrocardiographic (ECG) markers of atrial cardiomyopathy with heart failure (HF) and its subtypes is unclear.MethodsThis analysis included 6,754 participants free of clinical cardiovascular disease (CVD), including atrial fibrillation (AF), from the Multi-Ethnic Study...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-04-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1143338/full |
| _version_ | 1797839033693372416 |
|---|---|
| author | Muhammad Imtiaz Ahmad Mohammadtokir Mujtaba James S. Floyd Lin Y. Chen Elsayed Z. Soliman |
| author_facet | Muhammad Imtiaz Ahmad Mohammadtokir Mujtaba James S. Floyd Lin Y. Chen Elsayed Z. Soliman |
| author_sort | Muhammad Imtiaz Ahmad |
| collection | DOAJ |
| description | BackgroundThe association of electrocardiographic (ECG) markers of atrial cardiomyopathy with heart failure (HF) and its subtypes is unclear.MethodsThis analysis included 6,754 participants free of clinical cardiovascular disease (CVD), including atrial fibrillation (AF), from the Multi-Ethnic Study of Atherosclerosis. Five ECG markers of atrial cardiomyopathy (P-wave terminal force in V1 [PTFV1], deep-terminal negativity in V1 [DTNV1], P-wave duration [PWD], P-wave axis [PWA], advanced intra-atrial block [aIAB]) were derived from digitally recorded electrocardiograms. Incident HF events through 2018 were centrally adjudicated. An ejection fraction (EF) of 50% at the time of HF was used to classify HF as HF with reduced EF (HFrEF), HF with preserved EF (HFpEF), or unclassified HF. Cox proportional hazard models were used to examine the associations of markers of atrial cardiomyopathy with HF. The Lunn-McNeil method was used to compare the associations in HFrEF vs. HFpEF.Results413 HF events occurred over a median follow-up of 16 years. In adjusted models, abnormal PTFV1 (HR (95%CI): 1.56(1.15–2.13), abnormal PWA (HR (95%CI):1.60(1.16–2.22), aIAB (HR (95%CI):2.62(1.47–4.69), DTNPV1 (HR (95%CI): 2.99(1.63–7.33), and abnormal PWD (HR (95%CI): 1.33(1.02–1.73), were associated with increased HF risk. These associations persisted after further adjustments for intercurrent AF events. No significant differences in the strength of association of each ECG predictor with HFrEF and HFpEF were noted.ConclusionsAtrial cardiomyopathy defined by ECG markers is associated with HF, with no differences in the strength of association between HFrEF and HFpEF. Markers of atrial Cardiomyopathy may help identify individuals at risk of developing HF. |
| first_indexed | 2024-04-09T15:50:31Z |
| format | Article |
| id | doaj.art-299f49fb12ed47858eef7e186f84ca92 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-09T15:50:31Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-299f49fb12ed47858eef7e186f84ca922023-04-26T06:22:43ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-04-011010.3389/fcvm.2023.11433381143338Electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi-ethnic study of atherosclerosis (MESA) cohortMuhammad Imtiaz Ahmad0Mohammadtokir Mujtaba1James S. Floyd2Lin Y. Chen3Elsayed Z. Soliman4Department of Internal Medicine, Section on Hospital Medicine, Medical College of Wisconsin, Wauwatosa, WI, United StatesDepartment of Internal Medicine, Section on Hospital Medicine, Geisel School of Medicine, Dartmouth, NH, United StatesDepartments of Medicine and Epidemiology, University of Washington, Seattle, WA, United StatesLillehei Heart Institute and Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN, United StatesEpidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, United StatesBackgroundThe association of electrocardiographic (ECG) markers of atrial cardiomyopathy with heart failure (HF) and its subtypes is unclear.MethodsThis analysis included 6,754 participants free of clinical cardiovascular disease (CVD), including atrial fibrillation (AF), from the Multi-Ethnic Study of Atherosclerosis. Five ECG markers of atrial cardiomyopathy (P-wave terminal force in V1 [PTFV1], deep-terminal negativity in V1 [DTNV1], P-wave duration [PWD], P-wave axis [PWA], advanced intra-atrial block [aIAB]) were derived from digitally recorded electrocardiograms. Incident HF events through 2018 were centrally adjudicated. An ejection fraction (EF) of 50% at the time of HF was used to classify HF as HF with reduced EF (HFrEF), HF with preserved EF (HFpEF), or unclassified HF. Cox proportional hazard models were used to examine the associations of markers of atrial cardiomyopathy with HF. The Lunn-McNeil method was used to compare the associations in HFrEF vs. HFpEF.Results413 HF events occurred over a median follow-up of 16 years. In adjusted models, abnormal PTFV1 (HR (95%CI): 1.56(1.15–2.13), abnormal PWA (HR (95%CI):1.60(1.16–2.22), aIAB (HR (95%CI):2.62(1.47–4.69), DTNPV1 (HR (95%CI): 2.99(1.63–7.33), and abnormal PWD (HR (95%CI): 1.33(1.02–1.73), were associated with increased HF risk. These associations persisted after further adjustments for intercurrent AF events. No significant differences in the strength of association of each ECG predictor with HFrEF and HFpEF were noted.ConclusionsAtrial cardiomyopathy defined by ECG markers is associated with HF, with no differences in the strength of association between HFrEF and HFpEF. Markers of atrial Cardiomyopathy may help identify individuals at risk of developing HF.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1143338/fullheart failureatrial cardiomyopathyelectrocardiagrampreventionMESA (Multi-Ethnic study of atherosclerosis) |
| spellingShingle | Muhammad Imtiaz Ahmad Mohammadtokir Mujtaba James S. Floyd Lin Y. Chen Elsayed Z. Soliman Electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi-ethnic study of atherosclerosis (MESA) cohort Frontiers in Cardiovascular Medicine heart failure atrial cardiomyopathy electrocardiagram prevention MESA (Multi-Ethnic study of atherosclerosis) |
| title | Electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi-ethnic study of atherosclerosis (MESA) cohort |
| title_full | Electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi-ethnic study of atherosclerosis (MESA) cohort |
| title_fullStr | Electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi-ethnic study of atherosclerosis (MESA) cohort |
| title_full_unstemmed | Electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi-ethnic study of atherosclerosis (MESA) cohort |
| title_short | Electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi-ethnic study of atherosclerosis (MESA) cohort |
| title_sort | electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi ethnic study of atherosclerosis mesa cohort |
| topic | heart failure atrial cardiomyopathy electrocardiagram prevention MESA (Multi-Ethnic study of atherosclerosis) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1143338/full |
| work_keys_str_mv | AT muhammadimtiazahmad electrocardiographicmarkersofatrialcardiomyopathyandriskofheartfailureinthemultiethnicstudyofatherosclerosismesacohort AT mohammadtokirmujtaba electrocardiographicmarkersofatrialcardiomyopathyandriskofheartfailureinthemultiethnicstudyofatherosclerosismesacohort AT jamessfloyd electrocardiographicmarkersofatrialcardiomyopathyandriskofheartfailureinthemultiethnicstudyofatherosclerosismesacohort AT linychen electrocardiographicmarkersofatrialcardiomyopathyandriskofheartfailureinthemultiethnicstudyofatherosclerosismesacohort AT elsayedzsoliman electrocardiographicmarkersofatrialcardiomyopathyandriskofheartfailureinthemultiethnicstudyofatherosclerosismesacohort |