TY - JOUR
T1 - Association between excessive supraventricular ectopy and subclinical cerebrovascular disease
T2 - a population-based study
AU - on behalf of the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) Research Group
AU - Hisamatsu, T.
AU - Miura, K.
AU - Fujiyoshi, A.
AU - Kunimura, A.
AU - Ito, T.
AU - Miyazawa, I.
AU - Torii, S.
AU - Shiino, A.
AU - Nozaki, K.
AU - Kanda, H.
AU - Arima, H.
AU - Ohkubo, T.
AU - Ueshima, H.
N1 - Funding Information:
We thank the SESSA investigators, staff and study participants for their commitment and outstanding dedication. We also thank Ms Muramatsu for support with the analysis of 24-h Holter recordings. A full list of the SESSA investigators can be found at https://hs-web.shiga-med.ac.jp/se ssa/research/. This work was supported by a grant from the Kao Research Council for the Study of Healthcare Science (Tokyo, Japan); by grants from the Ministry of Education, Culture, Sports, Science and Technology Japan (17K15827, 25893097, A13307016, A17209023, A21249043, A23249036 and A25253046); and by a grant (HL068200) from the NIH. Dr Hisamatsu received an Overseas Research Fellowship grant from the JSPS.
Publisher Copyright:
© 2019 EAN
PY - 2019
Y1 - 2019
N2 - Background and purpose: The association between an increased supraventricular ectopic beat (SVEB) and subclinical cerebrovascular disease remains unclear. Given the emerging concept that an increased SVEB is a marker of atrial cardiomyopathy or atherosclerosis burden, we sought to determine whether excessive supraventricular ectopic activity (ESVEA) is associated with a higher burden of subclinical cerebrovascular disease in the middle-aged to older cohort with neither apparent stroke nor atrial fibrillation. Methods: We conducted a cross-sectional population-based study of 462 men (mean age, 68.1 years) who underwent 24-h Holter electrocardiography and brain magnetic resonance imaging. ESVEA was defined as the presence of >10 SVEBs/h. Subclinical cerebrovascular diseases were defined as silent brain infarct (SBI), white matter hyperintensity (WMH) and intracranial atherosclerotic stenosis (ICAS). The association of ESVEA with the presence of subclinical cerebrovascular diseases was adjusted for potential confounding covariates. Results: A total of 88 (19.0%) participants had ESVEA and 81 (17.5%), 91 (19.7%) and 109 (23.6%) had SBI, WMH and ICAS, respectively. In multivariable-adjusted Poisson regression with robust error variance, ESVEA was associated with the presence of WMH (relative risk, 1.58; 95% confidence interval, 1.06–2.36) and ICAS (relative risk, 1.49; 95% confidence interval, 1.02–2.18), but not with that of SBI (relative risk, 1.32; 95% confidence interval, 0.86–2.01). These associations were consistent when the graded distributions of subclinical cerebrovascular diseases were applied as outcomes in ordinal logistic regression. Conclusions: The ESVEA was independently associated with higher burdens of WMH and ICAS. This suggests that increased SVEBs might improve risk stratification of individuals at high risk of subclinical cerebrovascular disease and consequently apparent ischaemic stroke.
AB - Background and purpose: The association between an increased supraventricular ectopic beat (SVEB) and subclinical cerebrovascular disease remains unclear. Given the emerging concept that an increased SVEB is a marker of atrial cardiomyopathy or atherosclerosis burden, we sought to determine whether excessive supraventricular ectopic activity (ESVEA) is associated with a higher burden of subclinical cerebrovascular disease in the middle-aged to older cohort with neither apparent stroke nor atrial fibrillation. Methods: We conducted a cross-sectional population-based study of 462 men (mean age, 68.1 years) who underwent 24-h Holter electrocardiography and brain magnetic resonance imaging. ESVEA was defined as the presence of >10 SVEBs/h. Subclinical cerebrovascular diseases were defined as silent brain infarct (SBI), white matter hyperintensity (WMH) and intracranial atherosclerotic stenosis (ICAS). The association of ESVEA with the presence of subclinical cerebrovascular diseases was adjusted for potential confounding covariates. Results: A total of 88 (19.0%) participants had ESVEA and 81 (17.5%), 91 (19.7%) and 109 (23.6%) had SBI, WMH and ICAS, respectively. In multivariable-adjusted Poisson regression with robust error variance, ESVEA was associated with the presence of WMH (relative risk, 1.58; 95% confidence interval, 1.06–2.36) and ICAS (relative risk, 1.49; 95% confidence interval, 1.02–2.18), but not with that of SBI (relative risk, 1.32; 95% confidence interval, 0.86–2.01). These associations were consistent when the graded distributions of subclinical cerebrovascular diseases were applied as outcomes in ordinal logistic regression. Conclusions: The ESVEA was independently associated with higher burdens of WMH and ICAS. This suggests that increased SVEBs might improve risk stratification of individuals at high risk of subclinical cerebrovascular disease and consequently apparent ischaemic stroke.
KW - atrial cardiomyopathy
KW - electrocardiography
KW - epidemiology
KW - magnetic resonance imaging
KW - premature atrial contraction
KW - subclinical cerebrovascular disease/stroke
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U2 - 10.1111/ene.13970
DO - 10.1111/ene.13970
M3 - Article
C2 - 31002446
AN - SCOPUS:85065660376
SN - 1351-5101
VL - 26
SP - 1219
EP - 1225
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 9
ER -