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.

Renal disease and left atrial remodeling predict atrial fibrillation in patients with cardiovascular risk factors

2014 ◽  
Vol 175 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Angela Sciacqua ◽  
Maria Perticone ◽  
Giovanni Tripepi ◽  
Sofia Miceli ◽  
Eliezer J. Tassone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cardiovascular Risk ◽  
Renal Disease ◽  
Cardiovascular Risk Factors ◽  
Left Atrial ◽  
Atrial Remodeling ◽  
Left Atrial Remodeling

scholarly journals Racial Differences in the Incidence of Cardiovascular Risk Factors in Older Black and White Adults

2016 ◽  
Vol 65 (1) ◽  
pp. 83-90 ◽  
Author(s):  
George Howard ◽  
Monika M. Safford ◽  
Claudia S. Moy ◽  
Virginia J. Howard ◽  
Dawn O. Kleindorfer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Racial Differences ◽  
Black And White ◽  
White Adults

Abstract W P121: Stroke Severity in Men and Women: What Proportion of the Disparity Can Be Explained by Differences in Cardiovascular Risk Factors?

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Karen C Albright ◽  
Amelia K Boehme ◽  
Bisakha Sen ◽  
Monica Aswani ◽  
Michael T Mullen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Sex Differences ◽  
Cardiovascular Risk ◽  
Black Women ◽  
Cardiovascular Risk Factors ◽  
Stroke Severity ◽  
Stroke Subtype ◽  
Oaxaca Decomposition ◽  
Nihss Score

Background: Prior studies have shown that women present with more severe stroke. It has been suggested that sex differences in stroke severity are related to age, stroke subtype, or cardiovascular risk factors. We aimed to determine the proportion of sex disparity in stroke severity that can be explained by differences in these variables using Oaxaca decomposition, an econometric technique which quantifies the differences between groups. Methods: White and Black ischemic stroke patients who presented to two academic medical centers in the US (2004-2011) were identified using prospective stroke registries. In-hospital strokes were excluded. Patient demographics and medical history were collected. Stroke severity was measured by NIHSS. Linear regression was used to determine if female sex was associated with NIHSS score. This model was then adjusted for potential confounders including: age, race, stroke subtype, and cardiovascular risk factors. Oaxaca decomposition was then used to determine the proportion of the observed sex differences in stroke severity that can be explained by these variables. Results: 4925 patients met inclusion criteria. Nearly half (n=2346) were women and 39% (n=1942) were Black. Women presented with more severe strokes (median NIHSS 8 vs. 6). In addition, women were older on average (68 vs. 63 years) with more frequent atrial fibrillation (18% vs. 13%), diabetes (34% vs. 30%), and hypertension (78% vs. 72%). Oaxaca decomposition revealed that age, race, atrial fibrillation, large vessel etiology, diabetes, hypertension account for only 63% of the sex differences seen in NIHSS score on presentation. Conclusion: In our biracial sample, women presented with more severe strokes than men. This difference remained significant even after adjustment for age, stroke subtype, and cardiovascular risk factors. Further, over 1/3 of the observed gender difference in stroke severity was unexplained.. Additional study is warranted to investigate the etiology of the gender differences in stroke severity.

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.

Non-invasive assessment of endothelial activity in patients with coronary heart disease and cardiovascular risk factors

VASA ◽  
2008 ◽  
Vol 37 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Fronek ◽  
Allison
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cvd Risk ◽  
Hypertension Status ◽  
The Difference ◽  
Highly Correlated ◽  
And Gender

Background: The aim of this study was first to compare the widely used flow mediated dilation ( FMD ) method with the iontophoretically induced acetylcholine vasodilation (IAV ) procedure. The ultimate goal was to examine the endothelial activity ( EA ) in patients with various cardiovascular risk factors compared with control subjects. Patients and methods: In the upper extremities of 27 subjects, comparisons of EA by FMD and IAV measured with laser Doppler flux method (LDF) were conducted. IAV-EA was then measured using LDF in an additional 93 subjects with various cardiovascular ( CVD ) risk factors and/or a diagnosis of coronary heart disease (CHD). Results: The mean age of the subjects was 56.2 years and 54% were male. There was a robust and significant correlation between FMD vs IAV endothelial activity (r = 0.87, p = 0.025). After adjustment for age, there were significant differences in LDF-measured, acetylcholine-induced EA by diagnosis of CHD (p = 0.02), hyperlipidemia (p = 0.03) and diabetes (p < 0.01), as well as by sex (p < 0.01). The difference by hypertension status was of borderline significance (p = 0.07). LDF EA was higher in non-smokers compared to smokers but this difference was not statistically significant (p = 0.3). After adjustment for age and gender, a 10-unit increase in LDF-measured EA was associated with a 12% lower odds for a diagnosis of CHD (p = 0.07). Conclusions: Measurement of IAV-EA by LDF is a simple, noninvasive methodology which is highly correlated with post-occlusive FMD EA and is also significantly associated with a diagnosis of CHD.

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