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Ellisiv B Mathiesen - One of the best experts on this subject based on the ideXlab platform.
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Several common variants modulate heart rate, PR Interval and QRS duration
Nature Genetics, 2010Co-Authors: Hilma Holm, Daniel F Gudbjartsson, David O Arnar, Gudmar Thorleifsson, Gudmundur Thorgeirsson, Hrafnhildur Stefansdottir, Sigurjon A Gudjonsson, Aslaug Jonasdottir, Ellisiv B Mathiesen, Inger NjølstadAbstract:Electrocardiographic measures are indicative of the function of the cardiac conduction system. To search for sequence variants that modulate heart rate, PR Interval and QRS duration in individuals of European descent, we performed a genome-wide association study in ∼10,000 individuals and followed up the top signals in an additional ∼10,000 individuals. We identified several genome-wide significant associations (with P < 1.6 × 10^−7). We identified one locus for heart rate ( MYH6 ), four for PR Interval ( TBX5 , SCN10A , CAV1 and ARHGAP24 ) and four for QRS duration ( TBX5 , SCN10A , 6p21 and 10q21). We tested for association between these loci and subjects with selected arrhythmias in Icelandic and Norwegian case-control sample sets. We observed correlations between TBX5 and CAV1 and atrial fibrillation ( P = 4.0 × 10^−5 and P = 0.00032, respectively), between TBX5 and advanced atrioventricular block ( P = 0.0067), and between SCN10A and pacemaker implantation ( P = 0.0029). We also replicated PReviously described associations with the QT Interval. Hilma Holm and colleagues report genome-wide association studies to electrocardiographic measures of heart rate, PR Interval, QRS duration and QT Interval.
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several common variants modulate heart rate PR Interval and qrs duration
Nature Genetics, 2010Co-Authors: Hilma Holm, Daniel F Gudbjartsson, David O Arnar, Gudmar Thorleifsson, Gudmundur Thorgeirsson, Hrafnhildur Stefansdottir, Sigurjon A Gudjonsson, Aslaug Jonasdottir, Ellisiv B MathiesenAbstract:Hilma Holm and colleagues report genome-wide association studies to electrocardiographic measures of heart rate, PR Interval, QRS duration and QT Interval.
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several common variants modulate heart rate PR Interval and qrs duration
Nature Genetics, 2010Co-Authors: Hilma Holm, Daniel F Gudbjartsson, David O Arnar, Gudmar Thorleifsson, Gudmundur Thorgeirsson, Hrafnhildur Stefansdottir, Sigurjon A Gudjonsson, Aslaug Jonasdottir, Ellisiv B MathiesenAbstract:Electrocardiographic measures are indicative of the function of the cardiac conduction system. To search for sequence variants that modulate heart rate, PR Interval and QRS duration in individuals of European descent, we performed a genome-wide association study in apPRoximately 10,000 individuals and followed up the top signals in an additional apPRoximately 10,000 individuals. We identified several genome-wide significant associations (with P < 1.6 x 10(-7)). We identified one locus for heart rate (MYH6), four for PR Interval (TBX5, SCN10A, CAV1 and ARHGAP24) and four for QRS duration (TBX5, SCN10A, 6p21 and 10q21). We tested for association between these loci and subjects with selected arrhythmias in Icelandic and Norwegian case-control sample sets. We observed correlations between TBX5 and CAV1 and atrial fibrillation (P = 4.0 x 10(-5) and P = 0.00032, respectively), between TBX5 and advanced atrioventricular block (P = 0.0067), and between SCN10A and pacemaker implantation (P = 0.0029). We also replicated PReviously described associations with the QT Interval.
M.r. Gold - One of the best experts on this subject based on the ideXlab platform.
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The Impact of the PR Interval in Patients Receiving Cardiac Resynchronization Therapy: Results From the REVERSE Study
JACC. Clinical electrophysiology, 2017Co-Authors: J. Senfield, C. Daubert, W.t. Abraham, S. Ghio, J. Cerkvenik, C. Linde, Martin St. John Sutton, M.r. GoldAbstract:Abstract Objectives This study sought to evaluate the impact of baseline PR Interval on cardiac resynchronization therapy (CRT) outcomes in the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) study. Background The baseline electrocardiogram has important PRognostic value to determine response to CRT. Specifically, QRS duration and morphology are strong PRedictors of response and outcomes; however, the PRognostic importance of the PR Interval is less clear. Methods REVERSE was a double-blinded, randomized study of CRT in mild heart failure (HF). The PRimary endpoint was the analysis of patients in sinus rhythm (n = 582) of the time-to–first HF hospitalization or death during the 2-year randomized period of the trial. In addition, the long-term impact of PR Interval was assessed in the cohort actively on CRT during the PRe-planned 5-year follow-up. Subjects were analyzed by PR Interval, grouped by the median (180 ms) in 20-ms bins or as a continuous variable depending on the analysis performed. Secondary endpoints included the clinical composite score and echocardiographic measures of reverse remodeling. Results During the randomized phase of the study, CRT had similar effectiveness for both PR 180 ms (HR: 0.57) subgroups (interaction p = 0.33). Similar results were observed when PR Interval was grouped in 20-ms bins or treated as a continuous variable. In multivariable analysis of the long-term follow-up, left bundle branch block morphology, New York Heart Association functional class, HF etiology, and QRS duration, but not PR Interval, PRedicted HF hospitalization or death. Conclusions Baseline PR Interval does not affect clinical outcomes or reverse remodeling with CRT in mild HF. (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction [REVERSE]; NCT00271154)
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The Impact of the PR Interval in Patients Receiving Cardiac Resynchronization Therapy Results From the REVERSE Study
JACC: Clinical Electrophysiology, 2017Co-Authors: J. Senfield, C. Daubert, W.t. Abraham, S. Ghio, St.m. John Sutton, J. Cerkvenik, C. Linde, M.r. GoldAbstract:Objectives This study sought to evaluate the impact of baseline PR Interval on cardiac resynchronization therapy (CRT) outcomes in the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) study. Background The baseline electrocardiogram has important PRognostic value to determine response to CRT. Specifically, QRS duration and morphology are strong PRedictors of response and outcomes; however, the PRognostic importance of the PR Interval is less clear. Methods REVERSE was a double-blinded, randomized study of CRT in mild heart failure (HF). The PRimary endpoint was the analysis of patients in sinus rhythm (n = 582) of the time-to–first HF hospitalization or death during the 2-year randomized period of the trial. In addition, the long-term impact of PR Interval was assessed in the cohort actively on CRT during the PRe-planned 5-year follow-up. Subjects were analyzed by PR Interval, grouped by the median (180 ms) in 20-ms bins or as a continuous variable depending on the analysis performed. Secondary endpoints included the clinical composite score and echocardiographic measures of reverse remodeling. Results During the randomized phase of the study, CRT had similar effectiveness for both PR 180 ms (HR 0.57) subgroups (interaction p = 0.33). Similar results were observed when PR Interval was grouped in 20-ms bins or treated as a continuous variable. In multivariable analysis of the long-term follow-up, left bundle branch block morphology, New York Heart Association functional class, HF etiology, and QRS duration, but not PR Interval, PRedicted HF hospitalization or death. Conclusions Baseline PR Interval does not affect clinical outcomes or reverse remodeling with CRT in mild HF. (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction [REVERSE]; NCT00271154) © 2017 American College of Cardiology Foundation
Daniel F Gudbjartsson - One of the best experts on this subject based on the ideXlab platform.
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PR Interval genome-wide association meta-analysis identifies 50 loci associated with atrial and atrioventricular electrical activity
Nature Communications, 2018Co-Authors: Jessica Van Setten, Jennifer A. Brody, Yalda Jamshidi, Brenton R. Swenson, Anne M. Butler, Harry Campbell, Fabiola M. Del Greco, Daniel S. Evans, Quince Gibson, Daniel F GudbjartssonAbstract:Electrocardiographic PR Interval measures atrio-ventricular depolarization and conduction, and abnormal PR Interval is a risk factor for atrial fibrillation and heart block. Our genome-wide association study of over 92,000 European-descent individuals identifies 44 PR Interval loci (34 novel). Examination of these loci reveals known and PReviously not-yet-reported biological PRocesses involved in cardiac atrial electrical activity. Genes in these loci are over-rePResented in cardiac disease PRocesses including heart block and atrial fibrillation. Variants in over half of the 44 loci were associated with atrial or blood transcript exPRession levels, or were in high linkage disequilibrium with missense variants. Six additional loci were identified either by meta-analysis of ~105,000 African and European-descent individuals and/or by pleiotropic analyses combining PR Interval with heart rate, QRS Interval, and atrial fibrillation. These findings implicate developmental pathways, and identify transcription factors, ion-channel genes, and cell-junction/cell-signaling PRoteins in atrio-ventricular conduction, identifying potential targets for drug development. Abnormal PR Interval duration is associated with risk for atrial fibrillation and heart block. Here, van Setten et al. identify 44 PR Interval loci in a genome-wide association study of over 92,000 individuals and find genetic overlap with QRS duration, heart rate and atrial fibrillation.
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genome wide association meta analysis of PR Interval identifies 47 novel loci associated with atrial and atrioventricular electrical activity
bioRxiv, 2018Co-Authors: Jessica Van Setten, Jennifer A. Brody, Yalda Jamshidi, Brenton R. Swenson, Anne M. Butler, Harry Campbell, Daniel S. Evans, Quince Gibson, Fabiola M Del Greco, Daniel F GudbjartssonAbstract:Electrocardiographic PR Interval measures atrial and atrioventricular depolarization and conduction, and abnormal PR Interval is a risk factor for atrial fibrillation and heart block. We performed a genome-wide association study in over 92,000 individuals of European descent and identified 44 loci associated with PR Interval (34 novel). Examination of the 44 loci revealed known and novel biological PRocesses involved in cardiac atrial electrical activity, and genes in these loci were highly over-rePResented in several cardiac disease PRocesses. Nearly half of the 61 independent index variants in the 44 loci were associated with atrial or blood transcript exPRession levels, or were in high linkage disequilibrium with one or more missense variants. Cardiac regulatory regions of the genome as measured by cardiac DNA hypersensitivity sites were enriched for variants associated with PR Interval, compared to non-cardiac regulatory regions. Joint analyses combining PR Interval with heart rate, QRS Interval, and atrial fibrillation identified additional new pleiotropic loci. The majority of associations discovered in European-descent populations were also PResent in African-American populations. Meta-analysis examining over 105,000 individuals of African and European descent identified additional novel PR loci. These additional analyses identified another 13 novel loci. Together, these findings underscore the power of GWAS to extend knowledge of the molecular underpinnings of clinical PRocesses.
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Several common variants modulate heart rate, PR Interval and QRS duration
Nature Genetics, 2010Co-Authors: Hilma Holm, Daniel F Gudbjartsson, David O Arnar, Gudmar Thorleifsson, Gudmundur Thorgeirsson, Hrafnhildur Stefansdottir, Sigurjon A Gudjonsson, Aslaug Jonasdottir, Ellisiv B Mathiesen, Inger NjølstadAbstract:Electrocardiographic measures are indicative of the function of the cardiac conduction system. To search for sequence variants that modulate heart rate, PR Interval and QRS duration in individuals of European descent, we performed a genome-wide association study in ∼10,000 individuals and followed up the top signals in an additional ∼10,000 individuals. We identified several genome-wide significant associations (with P < 1.6 × 10^−7). We identified one locus for heart rate ( MYH6 ), four for PR Interval ( TBX5 , SCN10A , CAV1 and ARHGAP24 ) and four for QRS duration ( TBX5 , SCN10A , 6p21 and 10q21). We tested for association between these loci and subjects with selected arrhythmias in Icelandic and Norwegian case-control sample sets. We observed correlations between TBX5 and CAV1 and atrial fibrillation ( P = 4.0 × 10^−5 and P = 0.00032, respectively), between TBX5 and advanced atrioventricular block ( P = 0.0067), and between SCN10A and pacemaker implantation ( P = 0.0029). We also replicated PReviously described associations with the QT Interval. Hilma Holm and colleagues report genome-wide association studies to electrocardiographic measures of heart rate, PR Interval, QRS duration and QT Interval.
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several common variants modulate heart rate PR Interval and qrs duration
Nature Genetics, 2010Co-Authors: Hilma Holm, Daniel F Gudbjartsson, David O Arnar, Gudmar Thorleifsson, Gudmundur Thorgeirsson, Hrafnhildur Stefansdottir, Sigurjon A Gudjonsson, Aslaug Jonasdottir, Ellisiv B MathiesenAbstract:Hilma Holm and colleagues report genome-wide association studies to electrocardiographic measures of heart rate, PR Interval, QRS duration and QT Interval.
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several common variants modulate heart rate PR Interval and qrs duration
Nature Genetics, 2010Co-Authors: Hilma Holm, Daniel F Gudbjartsson, David O Arnar, Gudmar Thorleifsson, Gudmundur Thorgeirsson, Hrafnhildur Stefansdottir, Sigurjon A Gudjonsson, Aslaug Jonasdottir, Ellisiv B MathiesenAbstract:Electrocardiographic measures are indicative of the function of the cardiac conduction system. To search for sequence variants that modulate heart rate, PR Interval and QRS duration in individuals of European descent, we performed a genome-wide association study in apPRoximately 10,000 individuals and followed up the top signals in an additional apPRoximately 10,000 individuals. We identified several genome-wide significant associations (with P < 1.6 x 10(-7)). We identified one locus for heart rate (MYH6), four for PR Interval (TBX5, SCN10A, CAV1 and ARHGAP24) and four for QRS duration (TBX5, SCN10A, 6p21 and 10q21). We tested for association between these loci and subjects with selected arrhythmias in Icelandic and Norwegian case-control sample sets. We observed correlations between TBX5 and CAV1 and atrial fibrillation (P = 4.0 x 10(-5) and P = 0.00032, respectively), between TBX5 and advanced atrioventricular block (P = 0.0067), and between SCN10A and pacemaker implantation (P = 0.0029). We also replicated PReviously described associations with the QT Interval.
J. Senfield - One of the best experts on this subject based on the ideXlab platform.
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The Impact of the PR Interval in Patients Receiving Cardiac Resynchronization Therapy: Results From the REVERSE Study
JACC. Clinical electrophysiology, 2017Co-Authors: J. Senfield, C. Daubert, W.t. Abraham, S. Ghio, J. Cerkvenik, C. Linde, Martin St. John Sutton, M.r. GoldAbstract:Abstract Objectives This study sought to evaluate the impact of baseline PR Interval on cardiac resynchronization therapy (CRT) outcomes in the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) study. Background The baseline electrocardiogram has important PRognostic value to determine response to CRT. Specifically, QRS duration and morphology are strong PRedictors of response and outcomes; however, the PRognostic importance of the PR Interval is less clear. Methods REVERSE was a double-blinded, randomized study of CRT in mild heart failure (HF). The PRimary endpoint was the analysis of patients in sinus rhythm (n = 582) of the time-to–first HF hospitalization or death during the 2-year randomized period of the trial. In addition, the long-term impact of PR Interval was assessed in the cohort actively on CRT during the PRe-planned 5-year follow-up. Subjects were analyzed by PR Interval, grouped by the median (180 ms) in 20-ms bins or as a continuous variable depending on the analysis performed. Secondary endpoints included the clinical composite score and echocardiographic measures of reverse remodeling. Results During the randomized phase of the study, CRT had similar effectiveness for both PR 180 ms (HR: 0.57) subgroups (interaction p = 0.33). Similar results were observed when PR Interval was grouped in 20-ms bins or treated as a continuous variable. In multivariable analysis of the long-term follow-up, left bundle branch block morphology, New York Heart Association functional class, HF etiology, and QRS duration, but not PR Interval, PRedicted HF hospitalization or death. Conclusions Baseline PR Interval does not affect clinical outcomes or reverse remodeling with CRT in mild HF. (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction [REVERSE]; NCT00271154)
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The Impact of the PR Interval in Patients Receiving Cardiac Resynchronization Therapy Results From the REVERSE Study
JACC: Clinical Electrophysiology, 2017Co-Authors: J. Senfield, C. Daubert, W.t. Abraham, S. Ghio, St.m. John Sutton, J. Cerkvenik, C. Linde, M.r. GoldAbstract:Objectives This study sought to evaluate the impact of baseline PR Interval on cardiac resynchronization therapy (CRT) outcomes in the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) study. Background The baseline electrocardiogram has important PRognostic value to determine response to CRT. Specifically, QRS duration and morphology are strong PRedictors of response and outcomes; however, the PRognostic importance of the PR Interval is less clear. Methods REVERSE was a double-blinded, randomized study of CRT in mild heart failure (HF). The PRimary endpoint was the analysis of patients in sinus rhythm (n = 582) of the time-to–first HF hospitalization or death during the 2-year randomized period of the trial. In addition, the long-term impact of PR Interval was assessed in the cohort actively on CRT during the PRe-planned 5-year follow-up. Subjects were analyzed by PR Interval, grouped by the median (180 ms) in 20-ms bins or as a continuous variable depending on the analysis performed. Secondary endpoints included the clinical composite score and echocardiographic measures of reverse remodeling. Results During the randomized phase of the study, CRT had similar effectiveness for both PR 180 ms (HR 0.57) subgroups (interaction p = 0.33). Similar results were observed when PR Interval was grouped in 20-ms bins or treated as a continuous variable. In multivariable analysis of the long-term follow-up, left bundle branch block morphology, New York Heart Association functional class, HF etiology, and QRS duration, but not PR Interval, PRedicted HF hospitalization or death. Conclusions Baseline PR Interval does not affect clinical outcomes or reverse remodeling with CRT in mild HF. (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction [REVERSE]; NCT00271154) © 2017 American College of Cardiology Foundation
Elsayed Z Soliman - One of the best experts on this subject based on the ideXlab platform.
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Abstract 12973: PR-Interval Components and Atrial Fibrillation Risk: The Atherosclerosis Risk In Communities Study
Circulation, 2016Co-Authors: Wesley T. O'neal, Justin Smith, M. Benjamin Shoemaker, Lin Y. Chen, Alvaro Alonso, S. Patrick Whalen, Elsayed Z SolimanAbstract:Introduction: Reports on the association between the PR-Interval and atrial fibrillation (AF) are conflicting. We hypothesized that inconsistencies stem from that fact that the PR-Interval is not a single electrocardiographic (ECG) phenotype and it is more likely to rePResent a composite of several distinct components. Methods: We examined the association of the PR-Interval and its components (P-wave onset to P-wave peak duration, P-wave peak to P-wave end duration, and PR-segment) with AF in 14,924 participants (mean age=54±5.8 years; 26% black; 55% female) from the Atherosclerosis Risk in Communities study. The PR-Interval and its components were automatically measured at baseline (1987-1989) from standard 12-lead ECGs. PR-Interval >200 ms was considered PRolonged and values >95th percentile defined abnormal PR-Interval components. AF was ascertained during follow-up through December 31, 2010. Results: Over a median follow-up of 21.2 years, 1,985 (13%) participants developed AF. PRolonged PR-Interval was associated with an increased risk of AF (HR=1.19, 95% CI=1.02, 1.40). However, PR-Interval components showed varying levels of associations with AF (P-wave onset to P-wave peak duration: HR=1.57, 95%CI=1.31, 1.88; P-wave peak to P-wave end duration: HR=1.20, 95%CI=0.99, 1.46; and PR-segment: HR=1.05, 95%CI=0.85, 1.29). Additionally, the components of the PR-Interval had weak to moderate correlation with each other (correlation r ranged from -0.44 to 0.06). Conclusions: Our findings suggest the PR-Interval rePResents a composite of distinct components that are not uniformly associated with AF. Without considering the contribution of each component, inconsistent associations between the PR-Interval and AF are inevitable.
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PR-Interval Components and Atrial Fibrillation Risk (from the Atherosclerosis Risk in Communities Study).
The American journal of cardiology, 2016Co-Authors: Justin Smith, Wesley T. O'neal, M. Benjamin Shoemaker, Lin Y. Chen, Alvaro Alonso, S. Patrick Whalen, Elsayed Z SolimanAbstract:Reports on the association between the PR-Interval and atrial fibrillation (AF) are conflicting. We hypothesized that inconsistencies stem from that fact that the PR-Interval rePResents a composite of several distinct components. We examined the associations of the PR-Interval and its components (P-wave onset to P-wave peak duration, P-wave peak to P-wave end duration, and PR-segment) with incident AF in 14,924 participants (mean age 54 ± 5.8 years; 26% black; 55% women) from the Atherosclerosis Risk In Communities study. The PR-Interval and its components were automatically measured at baseline (1987 to 1989) from standard 12-lead electrocardiograms. PR-Interval >200 ms was considered PRolonged and values above the ninety-fifth percentile defined abnormal PR-Interval components. AF was ascertained during follow-up through December 31, 2010. Over a median follow-up of 21.2 years, 1,985 participants (13%) developed AF. PRolonged PR-Interval was associated with an increased risk of AF (hazard ratio [HR] 1.19, 95% confidence Interval [CI] 1.02 to 1.40). However, PR-Interval components showed varying levels of association with AF (P-wave onset to P-wave peak duration: HR 1.57, 95% CI 1.31 to 1.88; P-wave peak to P-wave end duration: HR 1.20, 95% CI 0.99 to 1.46; and PR-segment: HR 1.05, 95% CI 0.85 to 1.29). In addition, the components of the PR-Interval had weak-to-moderate correlation with each other (correlation r ranged from −0.44 to 0.06). In conclusion, our findings suggest the PR-Interval rePResents a composite of distinct components that are not uniformly associated with AF. Without considering the contribution of each component, inconsistent associations between the PR-Interval and AF are inevitable.
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explaining the inconsistent associations of PR Interval with mortality the role of p duration contribution to the length of PR Interval
Heart Rhythm, 2014Co-Authors: Elsayed Z Soliman, Michael W CammarataAbstract:Background There is a strong interest in PR Interval as a PRedictor for adverse outcomes. However, inconsistent reports have emerged. Objective The purpose of this study was to test the hypothesis that the significance of PR Interval as a PRedictor depends on the level of contribution of P duration to its length, a contribution that varies across populations. Methods We tested our hypothesis in 7501 participants from the Third National Health and Nutrition Examination Survey (NHANES III). Participants were divided into two subgroups based on the median P-duration contribution to PR Interval (P duration/PR Interval * 100). The risk of mortality associated with PRolonged (>200 ms) and short ( Results P-duration contribution to the length of PR Interval ranged from 30% to 90% (median 70%). During median follow-up of 13.8 years, 2541 deaths occurred. In a multivariable adjusted model, short but not PRolonged PR Interval was associated with mortality (hazard ratio [HR], (95% confidence Interval [CI]): 1.54 (1.18, 2.00) and 1.02 (0.90, 1.16), respectively). However, in a stratified analysis by P-duration contribution to PR Interval, both short and PRolonged PR Interval were associated with mortality in participants with high P-duration contribution (HR (95% CI):1.46 (1.10, 1.94) and 2.00 (1.34, 2.99), respectively) but not in participants with low P-duration contribution (HR (95% CI):1.53 (0.68, 3.41) and 0.99 (0.87, 1.13), respectively); interaction P = .008. Conclusion PR-Interval associations with outcomes are dictated by the level of contribution of P duration to its length, a contribution that has a wide range and is expected to vary across populations. These findings could explain the inconsistent reports of PR-Interval associations in different studies and call for caution when using PR Interval in risk PRediction models.
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Short-term repeatability of electrocardiographic P wave indices and PR Interval
Journal of electrocardiology, 2013Co-Authors: Michelle L Snyder, Elsayed Z Soliman, Eric A. Whitsel, Kapuaola S. Gellert, Gerardo HeissAbstract:Abstract Background P wave indices and PR Interval from 12-lead electrocardiograms (ECGs) are PRedictors of cardiovascular morbidity and mortality, but their repeatability has not been examined. Objectives Determine the short-term repeatability of P wave indices (P axis, maximum P area and duration, P dispersion and P terminal force in V1) and PR Interval. Methods Participants (n = 63) underwent two standard ECGs at each of two visits, two weeks apart. We calculated the intra-class correlation coefficient (ICC), weighted kappa, and minimal detectable change and difference. Results ICCs were 0.93 for PR Interval, 0.78 for P axis, 0.77 for maximum P area, and 0.58 for maximum P duration. Within- and between-visit Kappa were 0.30 and 0.11 for P dispersion, and 0.68 and 0.46 for P terminal force. Conclusion Repeatability of PR duration was excellent, that of P wave axis and maximum area was fair, and maximum P wave duration and terminal force was poor. Repeatability of P wave dispersion was fair within visit, yet poor between visits. These results illustrate potential biases when measurement error of some P wave indices is ignored in clinical and epidemiologic studies.
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association of blood PRessure and aortic distensibility with p wave indices and PR Interval the multi ethnic study of atherosclerosis mesa
Journal of Electrocardiology, 2013Co-Authors: Alvaro Alonso, Elsayed Z Soliman, Lin Y. Chen, David A Bluemke, Susan R HeckbertAbstract:Abstract Introduction Hypertension is an established risk factor for atrial fibrillation. Understanding the association of blood PRessure (BP) levels and aortic distensibility with P wave indices (PWIs) and PR Interval, intermediate phenotypes of atrial fibrillation, could PRovide insights into underlying mechanisms. Methods This analysis included 3180 men and women aged 45–84 years participating in the Multi-Ethnic Study of Atherosclerosis, a community-based cohort in the United States. Aortic distensibility was evaluated in 2243 of these individuals using cardiac magnetic resonance imaging. PWIs and PR Interval were automatically measured in standard 12-lead ECGs. Sitting BP and other cardiovascular risk factors were assessed using standardized PRotocols. Left ventricular mass was measured by magnetic resonance imaging. Results Higher systolic BP, and diastolic BPs and greater pulse PRessure were associated with a significantly greater P wave terminal force. These associations, however, were markedly attenuated or disappeared after adjustment for left ventricular mass. Systolic BP, diastolic BP, and pulse PRessure were not strongly associated with PR Interval or maximum P wave duration. Reduced aortic distensibility was associated with a longer PR Interval but not with PWIs: compared with individuals in the top quartile of aortic distensibility, participants in the lowest quartile had on average a 3.7-ms longer PR Interval (95% CI: 0.7, 6.7, p = 0.02), after multivariable adjustment. Conclusion In this large community-based sample, associations of BP and aortic distensibility with PWIs and PR Interval differed. These results suggest that PRocesses linking hypertension with the electrical substrate of atrial fibrillation, as characterized by these intermediate phenotypes, are diverse.