TY - JOUR
T1 - Right Ventricular Structure and Function Are Associated with Incident Atrial Fibrillation
T2 - MESA-RV Study (Multi-Ethnic Study of Atherosclerosis-Right Ventricle)
AU - Chatterjee, Neal A.
AU - Shah, Ravi V.
AU - Murthy, Venkatesh L.
AU - Praestgaard, Amy
AU - Shah, Sanjiv J.
AU - Ventetuolo, Corey E.
AU - Graham Barr, R.
AU - Kronmal, Richard
AU - Lima, Joao A.C.
AU - Bluemke, David A.
AU - Jerosch-Herold, Michael
AU - Alonso, Alvaro
AU - Kawut, Steven M.
N1 - Funding Information:
Dr Chatterjee was supported by National Heart, Lung, and Blood Institute T-32 HL-007575 which does not represent a relevant disclosure but does support time for writing. This study was funded by National Institutes of Health R01-HL086719, R01-HL077612, K24-HL103844, and N01-HC95159 through N01-HC95169.
Publisher Copyright:
© 2016 American Heart Association, Inc.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - 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.
AB - 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.
KW - Atrial fibrillation
KW - Heart failure
KW - Heart ventricles
KW - Magnetic resonance imaging
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U2 - 10.1161/CIRCEP.116.004738
DO - 10.1161/CIRCEP.116.004738
M3 - Article
C2 - 28082528
AN - SCOPUS:85009830219
SN - 1941-3149
VL - 10
JO - Circulation: Arrhythmia and Electrophysiology
JF - Circulation: Arrhythmia and Electrophysiology
IS - 1
M1 - e004738
ER -
