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Markers of Atrial Myopathy in the General Population: Prevalence, Predictors, and Inter-Relations
Linda S Johnson1, Pyotr G Platonov2, David Conen3
1Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Insights
Indirect markers of atrial myopathy are prevalent but weakly correlated in the general population. Different risk factors are associated with each marker, indicating a need for better diagnostic methods.
Area of Science:
- Cardiology
- Biomedical Imaging
- Epidemiology
Background:
- Atrial myopathy, linked to atrial fibrillation and stroke, lacks clear diagnostic criteria.
- Understanding its prevalence and correlates is crucial for clinical management.
- This study investigates potential markers for atrial myopathy.
Purpose of the Study:
- To assess the prevalence of atrial myopathy markers in a general population.
- To identify clinical correlates associated with these markers.
- To examine the overlap and correlations between different atrial myopathy indicators.
Main Methods:
- Utilized data from the Swedish CArdioPulmonary bioImage Study (SCAPIS) including 6,013 subjects.
- Assessed markers such as premature atrial complexes, left atrial volume index (LAVi), and P-wave indices from ECG and echocardiography.
- Analyzed associations with clinical factors including age, BMI, smoking, diabetes, and hypertension.
Main Results:
- 42% of participants exhibited at least one atrial myopathy marker.
- Weak correlation observed only between P-wave duration and LAVi (ρ=0.10, P=0.04).
- Distinct clinical correlates identified for premature atrial complexes (smoking, blood pressure, diabetes, CAD), LAVi (physical activity), and P-wave duration (BMI).
Conclusions:
- Indirect markers of atrial myopathy are common but poorly correlated in the general population.
- Different risk factors are associated with individual markers, highlighting heterogeneity.
- Further research is needed to develop accurate diagnostic methods for identifying individuals with atrial myopathy.
Background:
Atrial myopathy refers to structural and functional cardiac abnormalities associated with atrial fibrillation and stroke, but appropriate diagnostic criteria are lacking.
Objectives:
This study aimed to assess prevalence, clinical correlates, and overlap between potential atrial myopathy markers.
Methods:
The population-based SCAPIS (Swedish CArdioPulmonary bioImage Study) prospectively included 6,013 subjects without atrial fibrillation with 24-hour electrocardiograms. Resting electrocardiograms measuring P-wave indices were collected at 1 screening site (n = 1,201), and a random sample (n = 385) had echocardiographic left atrial volume index (LAVi). Atrial myopathy markers were defined as ≥500 premature atrial complexes/24 h, LAVi ≥34 mL/m2, P-wave duration >120 milliseconds, or P-wave terminal force in V1 >4,000 ms·s. Clinical correlates included age, sex, body mass index, height, smoking, physical activity, coronary artery disease, diabetes, systolic blood pressure, antihypertensive medication, and low education.
Results:
Atrial myopathy was common; 42% of the sample with all diagnostic modalities available had ≥1 atrial myopathy marker, but only 9% had 2 and 0.3% had ≥3. Only P-wave duration and LAVi were correlated (ρ = 0.10; P = 0.04). Clinical correlates of premature atrial complexes, P-wave indices, and LAVi differed; current smoking (34% increase; P < 0.001), systolic blood pressure (4%/mm Hg increase; P = 0.01), diabetes (35% increase; P = 0.001), and coronary artery disease (71% increase; P = 0.003) were associated with premature atrial complexes, physical activity ≥2 h/wk was associated with increased LAVi (β-coefficient = 3.1; P < 0.0001) and body mass index was associated with P-wave duration (β-coefficient = 0.4/kg/m2; P < 0.0001).
Conclusions:
In the general population, indirect markers of atrial myopathy are common but only weakly correlated, and their risk factor patterns are different. More studies are needed to accurately identify individuals with atrial myopathy with diagnostic methods.
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