Association of Left Atrial Function and Structure with Supra
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High levels of supraventricular ectopy has been observed in relation to a greater risk of atrial fibrillation, stroke, and death, according to MESA (Multi-Ethnic Study of Atherosclerosis) study.

But there exists little information regarding disparities by race/ethnicity in the extent of supraventricular ectopy, or concerning if high levels of supraventricular ectopy are related to impaired left atrial (LA) function and LA enlargement, says researchers from University of Washington.

Thus, to addressed these topics, they examined 1148 participants (47% men; mean age, 67 years) who had cardiovascular MRI in 2010-2012, followed by 14 days ambulatory electrocardiographic monitoring in 2016-2018.

Participant features and cardiovascular magnetic resonance measures of LA function as well as structure were analyzed in relation to average count of premature atrial contractions (PACs) per hour and average number of runs per day of supraventricular tachycardia.

In adjusted regression analyses, more PACs/hour were reported in relation to older age, male gender, White race, increased N-terminal pro-B-type natriuretic peptide, and a history of clinically detected atrial fibrillation.

On average fewer PACs/hour were noted in Chinese and Hispanic participants vs White participants.

Greater LA total emptying fraction was associated with fewer PACs/hour. Larger LA minimum volume was associated with more PACs/hour. Associations of LA volumes with runs of supraventricular tachycardia/day were similar in direction but were weaker.

Overall, findings revealed more PACs/hour, on extended ambulatory electrocardiographic monitoring, in relation to impaired LA function and LA enlargement. Information regarding the extent of atrial myopathy may be obtained by measuring supraventricular ectopy, researchers concluded.

They further mentioned that, “The associations of CMR measures with supraventricular ectopic beat (SVE) were little changed by adjustment for history of a cardiovascular event or in analyses restricted to those without a history of a cardiovascular event.” “Results were not materially changed after further adjustment for educational attainment, when chamber volumes were indexed to body surface area rather than the newly derived allometric indexes, or after exclusion of participants who reported use of sympathomimetic or dopaminergic agents.”

Examination of models fit with cubic splines did not provide evidence of departure from linearity in models examining CMR measures in relation to PAC frequency, the researchers commented.