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Association between excessive supraventricular ectopy and subclinical cerebrovascular disease: a population-based

T Hisamatsu1,2,3, K Miura3,4, A Fujiyoshi3

  • 1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

European Journal of Neurology
|April 20, 2019
PubMed

Insights

Excessive supraventricular ectopic beats (SVEBs) are linked to white matter hyperintensities and intracranial atherosclerotic stenosis in older adults. This finding may help identify individuals at higher risk for cerebrovascular disease.

Area of Science:

  • Cardiology
  • Neurology
  • Epidemiology

Background:

  • The relationship between increased supraventricular ectopic beats (SVEBs) and subclinical cerebrovascular disease is not well understood.
  • SVEBs may indicate atrial cardiomyopathy or atherosclerosis burden.

Purpose of the Study:

  • To investigate the association between excessive supraventricular ectopic activity (ESVEA) and subclinical cerebrovascular disease.
  • To determine if ESVEA is a marker for increased cerebrovascular disease burden in middle-aged to older adults without apparent stroke or atrial fibrillation.

Main Methods:

  • A cross-sectional study of 462 men (mean age 68.1 years) using 24-h Holter ECG and brain MRI.
  • ESVEA defined as >10 SVEBs/h. Subclinical cerebrovascular diseases included silent brain infarct (SBI), white matter hyperintensity (WMH), and intracranial atherosclerotic stenosis (ICAS).
  • Multivariable-adjusted Poisson regression and ordinal logistic regression were used to analyze associations.

Main Results:

  • 88 participants (19.0%) had ESVEA. 81 (17.5%) had SBI, 91 (19.7%) had WMH, and 109 (23.6%) had ICAS.
  • ESVEA was significantly associated with WMH (RR 1.58) and ICAS (RR 1.49) after multivariable adjustment.
  • No significant association was found between ESVEA and SBI (RR 1.32).

Conclusions:

  • Excessive supraventricular ectopic activity is independently associated with higher burdens of white matter hyperintensity and intracranial atherosclerotic stenosis.
  • Increased SVEBs may aid in risk stratification for subclinical cerebrovascular disease and subsequent ischemic stroke.
Abstract

Keywords:
atrial cardiomyopathyelectrocardiographyepidemiologymagnetic resonance imagingpremature atrial contractionsubclinical cerebrovascular disease/stroke

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