Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study
Background This study explored the association between childhood bradycardia and later‐life cardiac phenotype using longitudinal data from the 1946 National Survey of Health and Development (NSHD) birth cohort. Methods and Results Resting heart rate was recorded at 6 and 7 years of age to provide th...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-10-01
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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.121.021877 |
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| author | Constantin‐Cristian Topriceanu James C. Moon Rebecca Hardy Alun D. Hughes Gabriella Captur |
| author_facet | Constantin‐Cristian Topriceanu James C. Moon Rebecca Hardy Alun D. Hughes Gabriella Captur |
| author_sort | Constantin‐Cristian Topriceanu |
| collection | DOAJ |
| description | Background This study explored the association between childhood bradycardia and later‐life cardiac phenotype using longitudinal data from the 1946 National Survey of Health and Development (NSHD) birth cohort. Methods and Results Resting heart rate was recorded at 6 and 7 years of age to provide the bradycardia exposure defined as a childhood resting heart rate <75 bpm. Three outcomes were studied: (1) echocardiographic data at 60 to 64 years of age, consisting of ejection fraction, left ventricular mass index, myocardial contraction fraction index, and E/e′; (2) electrocardiographic evidence of atrioventricular or ventricular conduction defects by 60 to 64 years of age; and (3) all‐cause and cardiovascular mortality. Generalized linear models or Cox regression models were used, and adjustment was made for relevant demographic and health‐related covariates, and for multiple testing. Mixed generalized linear models and fractional polynomials were used as sensitivity analyses. One in 3 older adults with atrioventricular conduction defects had been bradycardic in childhood, with defects being serious (Mobitz type II second‐degree atrioventricular block or higher) in 12%. In fully adjusted models, childhood bradycardia was associated with 2.91 higher odds of atrioventricular conduction defects (95% CI, 1.59–5.31; P=0.0005). Associations persisted in random coefficients mixed generalized linear models (odds ratio, 2.50; 95% CI, 1.01–4.31). Fractional polynomials confirmed a linear association between the log odds of atrioventricular conduction defects at 60 to 64 years of age and resting heart rate at 7 years of age. There was no association between bradycardia in childhood and mortality outcomes or with echocardiographic parameters and ventricular conduction defects in older age. Conclusions Longitudinal birth cohort data indicate that childhood bradycardia trebles the odds of having atrioventricular conduction defects in older age, 88% of which are benign. In addition, it does not influence mortality or heart size and function. Future research should concentrate on identifying children at risk. |
| first_indexed | 2024-04-10T18:24:39Z |
| format | Article |
| id | doaj.art-84d2606ad4b94418b95296c46a36f03f |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T18:24:39Z |
| publishDate | 2021-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-84d2606ad4b94418b95296c46a36f03f2023-02-02T06:18:44ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-10-01101910.1161/JAHA.121.021877Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort StudyConstantin‐Cristian Topriceanu0James C. Moon1Rebecca Hardy2Alun D. Hughes3Gabriella Captur4University College London (UCL) Medical Research Council (MRC) Unit for Lifelong Health and AgeingUniversity College London London United KingdomUCL Institute of Cardiovascular Science University College London London United KingdomCLOSER Social Research Institute London United KingdomUniversity College London (UCL) Medical Research Council (MRC) Unit for Lifelong Health and AgeingUniversity College London London United KingdomUniversity College London (UCL) Medical Research Council (MRC) Unit for Lifelong Health and AgeingUniversity College London London United KingdomBackground This study explored the association between childhood bradycardia and later‐life cardiac phenotype using longitudinal data from the 1946 National Survey of Health and Development (NSHD) birth cohort. Methods and Results Resting heart rate was recorded at 6 and 7 years of age to provide the bradycardia exposure defined as a childhood resting heart rate <75 bpm. Three outcomes were studied: (1) echocardiographic data at 60 to 64 years of age, consisting of ejection fraction, left ventricular mass index, myocardial contraction fraction index, and E/e′; (2) electrocardiographic evidence of atrioventricular or ventricular conduction defects by 60 to 64 years of age; and (3) all‐cause and cardiovascular mortality. Generalized linear models or Cox regression models were used, and adjustment was made for relevant demographic and health‐related covariates, and for multiple testing. Mixed generalized linear models and fractional polynomials were used as sensitivity analyses. One in 3 older adults with atrioventricular conduction defects had been bradycardic in childhood, with defects being serious (Mobitz type II second‐degree atrioventricular block or higher) in 12%. In fully adjusted models, childhood bradycardia was associated with 2.91 higher odds of atrioventricular conduction defects (95% CI, 1.59–5.31; P=0.0005). Associations persisted in random coefficients mixed generalized linear models (odds ratio, 2.50; 95% CI, 1.01–4.31). Fractional polynomials confirmed a linear association between the log odds of atrioventricular conduction defects at 60 to 64 years of age and resting heart rate at 7 years of age. There was no association between bradycardia in childhood and mortality outcomes or with echocardiographic parameters and ventricular conduction defects in older age. Conclusions Longitudinal birth cohort data indicate that childhood bradycardia trebles the odds of having atrioventricular conduction defects in older age, 88% of which are benign. In addition, it does not influence mortality or heart size and function. Future research should concentrate on identifying children at risk.https://www.ahajournals.org/doi/10.1161/JAHA.121.021877atrioventricular conduction defectscardiovascular diseasechildhood bradycardia |
| spellingShingle | Constantin‐Cristian Topriceanu James C. Moon Rebecca Hardy Alun D. Hughes Gabriella Captur Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrioventricular conduction defects cardiovascular disease childhood bradycardia |
| title | Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study |
| title_full | Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study |
| title_fullStr | Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study |
| title_full_unstemmed | Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study |
| title_short | Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study |
| title_sort | childhood bradycardia associates with atrioventricular conduction defects in older age a longitudinal birth cohort study |
| topic | atrioventricular conduction defects cardiovascular disease childhood bradycardia |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.021877 |
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