Abstract 14520: Differences in Left Atrial Size and Function and Supraventricular Arrhythmias Between Blacks and Whites in the Atherosclerosis Risk in Communities (ARIC) Study: Implications for AF Pathogenesis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Wendy Wang ◽  
Riccardo M Inciardi ◽  
Faye L Norby ◽  
Michael J Zhang ◽  
Jorge L Reyes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Racial Differences ◽  
Left Atrial ◽  
Atherosclerosis Risk In Communities ◽  
Significant Difference ◽  
Blacks And Whites ◽  
The Difference ◽  
And Function ◽  
Aric Study ◽  
Age And Sex

Introduction: Black Americans have more atrial fibrillation (AF) risk factors but lower AF risk than whites. Left atrial (LA) enlargement, impaired LA function, frequent premature atrial contractions (PAC), and atrial tachycardia (AT) are risk factors for AF. Racial differences in LA size and function, PAC, or AT may exist that could explain the difference in AF risk. Hypothesis: Whites have higher PAC and AT frequency than blacks. Additionally, whites have larger LA size and lower LA function than blacks, which may contribute to the racial difference in AF. Methods: We included 1,623 ARIC participants free of AF who had 2D-echocardiograms at visit 5 (2011-2013) and wore a 2-week continuous heart monitor, the Zio ® XT Patch, at visit 6 (2016-2017). Weighted linear regression was used to analyze the association of race with LA size and function, as well as runs of AT per day and PAC per hour. Results: At visit 5, participants were 74 (4) years old, 58% were female, and 26% were black. AT runs were detected in 87% of blacks and 92% of whites, respectively (p=0.002). Among participants with >0 runs of AT per day (n=1480), blacks had 48% (95% CI: 21%-66%) fewer runs of AT per day than whites after adjustment for cardiovascular (CV) risk factors † . There was no significant difference in PAC frequency between blacks and whites. After adjusting for age and sex, blacks had greater LA size and lower LA function than whites; these differences attenuated after adjusting for CV risk factors (Table). Conclusion: Blacks have greater age and sex-adjusted abnormality in LA size and function than whites, likely due to higher prevalence of CV risk factors. Yet, blacks have lower propensity for AT. More research is needed to elucidate the mechanisms underlying the resistance to atrial arrhythmogenesis in blacks despite greater adverse LA remodeling.

scholarly journals Differences in Left Atrial Size and Function and Supraventricular Ectopy Between Black and White Participants in the ARIC Study

2021 ◽  
Author(s):  
Wendy Wang ◽  
Faye L. Norby ◽  
Michael J. Zhang ◽  
Jorge L. Reyes ◽  
Amil M. Shah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Racial Differences ◽  
Left Atrial ◽  
Future Research ◽  
Atrial Remodeling ◽  
Black And White ◽  
The Difference

Background Black Americans have more atrial fibrillation risk factors but lower atrial fibrillation risk than White Americans. Left atrial (LA) enlargement and/or dysfunction, frequent atrial tachycardia (AT), and premature atrial contractions (PAC) are associated with increased atrial fibrillation risk. Racial differences in these factors may exist that could explain the difference in atrial fibrillation risk. Methods and Results We included 2133 ARIC (Atherosclerosis Risk in Communities) study participants (aged 74±4.5 years[mean±SD], 59% women, 27% Black participants) who had echocardiograms in 2011 to 2013 and wore the Zio XT Patch (a 2‐week continuous heart monitor) in 2016 to 2017. Linear regression was used to analyze (1) differences in AT/day or PAC/hour between Black and White participants, (2) differences in LA measures between Black and White participants, and (3) racial differences in the association of LA measures with AT or PAC frequency. Compared with White participants, Black participants had a higher prevalence of cardiovascular risk factors and disease, lower AT frequency, greater LA size, and lower LA function. After multivariable adjustments, Black participants had 37% (95% CI, 24%–47%) fewer AT runs/day than White participants. No difference in PAC between races was noted. Greater LA size and reduced LA function are associated with more AT and PAC runs; however, no race interaction was present. Conclusions Differences in LA measures are unlikely to explain the difference in atrial fibrillation risk between Black and White individuals. Despite more cardiovascular risk factors and greater atrial remodeling, Black participants have lower AT frequency than White participants. Future research is needed to elucidate the protective mechanisms that confer resilience to atrial arrhythmias in Black individuals.

scholarly journals B-PO04-157 REFINING PREDICTION OF THE POOLED COHORT EQUATIONS WITH LEFT ATRIAL SIZE AND FUNCTION: THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S342
Author(s):  
Michael Jingyuan Zhang ◽  
Wendy Wang ◽  
Riccardo Inciardi ◽  
Faye L. Norby ◽  
Pamela Lutsey ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Size ◽  
Atherosclerosis Risk In Communities ◽  
Atrial Size ◽  
Atherosclerosis Risk ◽  
And Function ◽  
Aric Study

scholarly journals Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study

Neurology ◽  
2011 ◽  
Vol 78 (2) ◽  
pp. 102-108 ◽  
Author(s):  
D. C. Bezerra ◽  
A. R. Sharrett ◽  
K. Matsushita ◽  
R. F. Gottesman ◽  
D. Shibata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

scholarly journals Vital exhaustion and sudden cardiac death in the Atherosclerosis Risk in Communities Study

Heart ◽  
2017 ◽  
Vol 104 (5) ◽  
pp. 423-429 ◽  
Author(s):  
Brittany M Bogle ◽  
Nona Sotoodehnia ◽  
Anna M Kucharska-Newton ◽  
Wayne D Rosamond
Keyword(s):  
Risk Factors ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Disease Risk ◽  
Ventricular Tachyarrhythmia ◽  
Atherosclerosis Risk In Communities ◽  
Vital Exhaustion ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Aric Study

ObjectiveVital exhaustion (VE), a construct defined as lack of energy, increased fatigue and irritability, and feelings of demoralisation, has been associated with cardiovascular events. We sought to examine the relation between VE and sudden cardiac death (SCD) in the Atherosclerosis Risk in Communities (ARIC) Study.MethodsThe ARIC Study is a predominately biracial cohort of men and women, aged 45–64 at baseline, initiated in 1987 through random sampling in four US communities. VE was measured using the Maastricht questionnaire between 1990 and 1992 among 13 923 individuals. Cox proportional hazards models were used to examine the hazard of out-of-hospital SCD across tertiles of VE scores.ResultsThrough 2012, 457 SCD cases, defined as a sudden pulseless condition presumed due to a ventricular tachyarrhythmia in a previously stable individual, were identified in ARIC by physician record review. Adjusting for age, sex and race/centre, participants in the highest VE tertile had an increased risk of SCD (HR 1.48, 95% CI 1.17 to 1.87), but these findings did not remain significant after adjustment for established cardiovascular disease risk factors (HR 0.94, 95% CI 0.73 to 1.20).ConclusionsAmong participants of the ARIC study, VE was not associated with an increased risk for SCD after adjustment for cardiovascular risk factors.

Effect of Tobacco on Lipoprotein Profile: A Comparative study among Smokers and Chewers

2021 ◽  
pp. 4973-4976
Author(s):  
Roshan Kumar Jha ◽  
Ranjit S. Ambad ◽  
Priya Koundal ◽  
Akansha Singh
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Total Cholesterol ◽  
Sample Processing ◽  
Exclusion Criteria ◽  
Future Studies ◽  
Area Of Interest ◽  
Significant Difference ◽  
The Difference

It has been proved that tobacco is one of the cholesterol dependent risk factors pathogenically, and in addition with other risk factors it may lead to coronary heart disease. Thus, a strong interaction exists between hypercholesterolemia and tobacco ingesting in the genesis of coronary heart disease. The aim of this study was to study the effect of tobacco smoking and chewing and compare its effect on lipoproteins. 60 subjects were included in the study, and were grouped into 3 three groups, tobacco smokers, tobacco chewers and tobacco non-abusers. Each group comprises 20 participants: selected on the basis of inclusion and exclusion criteria. Proper sampling and sample processing methods were employed to evaluate lipid profile. Total cholesterol and triglycerides levels were increased in smokers in comparison to non-smokers/non-chewers, and the differences were significant p<0.0001. HDL level was decreased in smokers as compared to non-smokers/non-chewers and the difference was statistically significant p<0.0001. Total cholesterol and LDL levels were increased in smokers in comparison to chewers. HDL level was decreased in chewers as compared to chewers. There was no significant association in any of the parameters. Present study observed increased and significant p<0.0001 differences in levels of total cholesterol and triglycerides while, HDL levels were decreased significantly p<0.0001, and also observed there was no significant difference among tobacco smokers and chewers. This may be a new area of interest for future studies.

Abstract P230: Markers of Hyperglycemia and Intracranial Atherosclerotic Stenosis by Magnetic Resonance Angiography

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Akira Fujiyoshi ◽  
M.Fareed K Suri ◽  
Alvaro Alonso ◽  
Elizabeth Selvin ◽  
Haitao Chu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Atherosclerosis Risk In Communities ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
History Of ◽  
Diagnosed Diabetes ◽  
Aric Study

Introduction: Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke. Determinants of ICAS include conventional cardiovascular (CV) risk factors such as hypertension and dyslipidemia. The association of diabetes mellitus (DM) and/or hyperglycemia with ICAS, however, is less well documented. Hypothesis: In a community-based population, biomarkers of hyperglycemia will be cross-sectionally associated with prevalent ICAS independent of CV risk factors. Methods: Our analyses were conducted in a subsample of participants of the Atherosclerosis Risk in Communities (ARIC) Study who participated in the ARIC-Neurocognitive Study in 2011-13 with cerebrovascular magnetic resonance angiography and no history of stroke. For the present analyses, we grouped the participants into 3 categories based on the highest ICAS category among any of the intracranial arteries we assessed: “no stenosis”, “<50%”, or “≥50% (including occlusion)”. Diagnosed diabetes was defined as self-reported physician diagnosis or use of antidiabetic medication. Ordinal logistic regression provided odds ratios of prevalent ICAS according to quintile of glucose or glycated hemoglobin (HbA1c) adjusted for CV risk factors. Results (Table): There were 1,658 individuals included in our study (age 67-90 years, women 58%, Black 29%), 31% (514/1658) had diagnosed diabetes, 10% (165/1658) had ≥50 % stenosis at any of the intracerebral arteries. In crude analyses, those with higher glucose and HbA1c were more likely to have ICAS among the non-diabetes and the diabetes. In logistic regression, highest quintile of glucose, relative to the lowest, had odds ratio of 2.26 (95% confidence interval 1.48, 3.45) for being in each successive ICAS category after adjustment for CV risk factors. Conclusion: Higher glucose and HbA1c were associated with higher odds of ICAS independent of CV risk factors. The finding suggests that hyperglycemia plays a role in pathogenesis of ICAS.

Abstract 183: Depressive Symptoms and Incident Stroke in Black and White Participants in the REGARDS Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Audrey L Austin ◽  
Michael G Crowe ◽  
Martha R Crowther ◽  
Virginia J Howard ◽  
Abraham J Letter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Depressive Symptoms ◽  
Racial Differences ◽  
Stroke Risk ◽  
Depression Scale ◽  
Stroke Incidence ◽  
Blacks And Whites ◽  
The Impact

Background and Purpose: Research suggests that depression may contribute to stroke risk independent of other known risk factors. Most studies examining the impact of depression on stroke have been conducted with predominantly white cohorts, though blacks are known to have higher stroke incidence than whites. The purpose of this study was to examine depressive symptoms as a risk factor for incident stroke in blacks and whites, and determine whether depressive symptomatology was differentially predictive of stroke among blacks and whites. Methods: The REasons for Geographic and Racial Differences in Stroke (REGARDS), is a national, population-based longitudinal study designed to examine risk factors associated with black-white and regional disparities in stroke incidence. Among 30,239 participants (42% black) accrued from 2003-2007, excluding those lacking follow-up or data on depressive symptoms, 27,557 were stroke-free at baseline. As of the January 2011 data closure, over an average follow-up of 4.6 years, 548 incident stroke cases were verified by study physicians based on medical records review. The association between baseline depressive symptoms (assessed via the Center for Epidemiological Studies Depression scale, 4-item version) and incident stroke was analyzed with Cox proportional hazards models adjusted for demographic factors (age, race, and sex), stroke risk factors (hypertension, diabetes, smoking, atrial fibrillation, and history of heart disease), and social factors (education, income, and social network). Results: For the total sample, depressive symptoms were predictive of incident stroke. The association between depressive symptoms and stroke did not differ significantly based on race (Wald X 2 = 2.38, p = .1229). However, race-stratified analyses indicated that the association between depressive symptoms and stroke was stronger among whites and non-significant among blacks. Conclusions: Depressive symptoms were an independent risk factor for incident stroke among a national sample of blacks and whites. These findings suggest that assessment of depressive symptoms may warrant inclusion in stroke risk scales. The potential for a stronger association in whites than blacks requires further study.

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