Subclinical Atrial Fibrillation and Supraventricular Ectopy in the Jackson Heart Study

杰克逊心脏研究中的亚临床心房颤动和室上性异位

• 批准号: 10459370
• 负责人: James S Floyd
• 金额: $ 82.24万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10459370
• 关键词: Adhesives; African American population; Age; Ancillary Study; Anticoagulants; Arrhythmia; Atherosclerosis Risk in Communities; Atrial Fibrillation; Blood Pressure; Brain; Brain natriuretic peptide; Cardiac; Cardioscopes; Cardiovascular Diseases; Cessation of life; Clinical; Cohort Studies; Contracts; Cross-Sectional Studies; Data; Detection; Devices; Electrocardiogram; Frequencies; Functional disorder; Funding; Genetic Variation; Goals; Heart Atrium; Heart failure; High Prevalence; Holter Electrocardiography; Hypertension; Hypokalemia; Impaired cognition; Individual; Jackson Heart Study; Knowledge; Lead; Magnetic Resonance Imaging; Measurement; Measures; Methods; Monitor; Multi-Ethnic Study of Atherosclerosis; Myocardial Infarction; N-terminal; National Heart, Lung, and Blood Institute; Opioid; Participant; Patients; Pharmaceutical Preparations; Population; Potassium; Prevalence; Prevention; Prevention strategy; Prospective cohort study; Psychosocial Factor; Reporting; Research; Rest; Risk; Risk Factors; Serum; Strategic vision; Stroke; Structure; Surveillance Methods; Symptoms; Time; brain abnormalities; brain magnetic resonance imaging; cardiovascular disorder prevention; cardiovascular disorder risk; clinical risk; cognitive function; cognitive testing; detection method; health difference; imaging study; implantable device; improved; longitudinal analysis; modifiable risk; monitoring device; novel; pro-brain natriuretic peptide (1-76); racial difference; screening; sex; stroke risk; treatment strategy

ABSTRACT Atrial fibrillation (AF) is a common arrhythmia that can have devastating consequences, including stroke and accelerated decline in cognitive function. Because AF is often asymptomatic and escapes clinical detection (subclinical AF), conventional methods for identifying AF have underestimated the population burden of AF. African Americans have a lower risk of clinically-recognized AF than whites, yet they suffer more stroke and cognitive impairment. A high prevalence of subclinical AF and of another important arrhythmia, supraventricular ectopy (SVE), may help to explain this paradox. In addition, several emerging risk factors for AF and SVE, including long-term changes in blood pressure, hypokalemia, the use of certain medications, and psychosocial factors, are modifiable and represent potential targets for AF prevention. The use of sensitive and unbiased methods to detect AF and SVE, and the discovery of novel modifiable risk factors for these arrhythmias, may offer opportunities for improved cardiovascular disease (CVD) prevention among African Americans. Our project will use a non-invasive electrocardiographic (ECG) monitoring device that is both well- tolerated and sensitive for detecting subclinical arrhythmia to measure subclinical AF, AF type (paroxysmal vs. persistent), and SVE frequency. In this ancillary study, we propose to conduct 14-day continuous ECG monitoring on 2,000 participants who return for Field Center Exam 4 of the Jackson Heart Study (JHS), a large prospective cohort study of CVD risk factors in African Americans. We will also use data from anticipated contract funded components of the Field Center Exam, including cognitive assessments and brain magnetic resonance imaging (MRI). Our goals are to assess the population burden of subclinical AF and SVE among African Americans, and to identify correlates of subclinical AF and SVE that may be modifiable risk factors or consequences of these arrhythmias. There are four aims. Aim 1: Estimate the age- and sex-specific prevalence of subclinical AF and AF type (paroxysmal vs. persistent) among African Americans in the JHS, and compare with the prevalence of subclinical AF and AF type among white participants undergoing 14-day continuous ECG monitoring in the Multi-Ethnic Study of Atherosclerosis and the Atherosclerosis Risk in Communities Study. Aim 2: Using data from JHS Exams 1-4, (a) evaluate whether traditional AF risk factors are associated with subclinical AF and SVE, and (b) identify novel, modifiable risk factors for these arrhythmias. Aim 3: Evaluate the utility of a clinical AF risk score, NT-proBNP levels, and risk factors identified from Aim 2 for the prediction of subclinical AF. Aim 4: In cross-sectional analyses, determine whether subclinical AF and SVE are associated with worse cognitive function and with brain MRI abnormalities. This project will generate new knowledge about subclinical AF and SVE that will be relevant to patients, and that will inform prevention and treatment strategies to reduce the burden of AF and AF-related complications among African Americans.

抽象的 心房颤动 (AF) 是一种常见的心律失常，可能会造成毁灭性的后果，包括 中风和认知功能加速下降。因为 AF 通常无症状并且逃避临床 检测（亚临床 AF），识别 AF 的传统方法低估了人群 房颤的负担。非裔美国人患临床公认的房颤的风险比白人低，但他们遭受的痛苦却更多 中风和认知障碍。亚临床房颤和另一种重要心律失常的患病率很高， 室上性异位（SVE），可能有助于解释这一悖论。此外，一些新出现的风险因素 对于 AF 和 SVE，包括血压的长期变化、低钾血症、某些药物的使用、 和心理社会因素，是可以改变的，代表了房颤预防的潜在目标。使用敏感 检测 AF 和 SVE 的公正方法，以及发现这些新的可改变的危险因素 心律失常，可能为改善非洲心血管疾病（CVD）预防提供机会 美国人。我们的项目将使用一种非侵入性心电图 (ECG) 监测设备，该设备具有良好的 对于检测亚临床心律失常、测量亚临床 AF、AF 类型（阵发性与阵发性）具有耐受性和敏感性。 持续）和 SVE 频率。在这项辅助研究中，我们建议进行 14 天的连续心电图检查 对返回参加杰克逊心脏研究 (JHS) 现场中心考试 4 的 2,000 名参与者进行监测，该研究是一项大型研究 非裔美国人 CVD 危险因素的前瞻性队列研究。我们还将使用来自预期的数据 现场中心考试的合同资助部分，包括认知评估和脑磁 磁共振成像（MRI）。我们的目标是评估亚临床 AF 和 SVE 的人口负担 非裔美国人，并确定亚临床 AF 和 SVE 的相关性，这些相关性可能是可改变的风险因素或 这些心律失常的后果。有四个目标。目标 1：估计特定年龄和性别的 JHS 地区非裔美国人亚临床 AF 和 AF 类型（阵发性与持续性）的患病率， 并与接受 14 天治疗的白人参与者中亚临床 AF 和 AF 类型的患病率进行比较 动脉粥样硬化多种族研究中的连续心电图监测和动脉粥样硬化风险 社区研究。目标 2：使用 JHS 考试 1-4 的数据，(a) 评估传统 AF 风险因素是否 与亚临床 AF 和 SVE 相关，并且 (b) 确定这些心律失常的新的、可改变的危险因素。 目标 3：评估临床 AF 风险评分、NT-proBNP 水平以及目标 2 中确定的风险因素的效用 用于预测亚临床 AF。目标 4：在横断面分析中，确定亚临床 AF 和 SVE 与较差的认知功能和脑部 MRI 异常有关。该项目将生成 关于亚临床 AF 和 SVE 的新知识将与患者相关，并将为预防提供信息 以及减轻非洲裔美国人房颤和房颤相关并发症负担的治疗策略。

项目成果

Response to "ACE-2 Downregulation and Incidence of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) Infection".

对“ACE-2 下调和严重急性呼吸综合征-冠状病毒-2 (SARS-CoV-2) 感染的发生率”的回应。

• 发表时间: 2021
• 影响因子: 3.2
• 作者: Dublin, Sascha;Walker, Rod L;Floyd, James S;Shortreed, Susan M;Fuller, Sharon;Albertson;Harrington, Laura B;Greenwood;Green, Beverly B;Psaty, Bruce M
• 通讯作者: Psaty, Bruce M

Kidney Function and Subclinical Arrhythmias: The Multi-Ethnic Study of Atherosclerosis.

肾功能和亚临床心律失常：动脉粥样硬化的多种族研究。

• 发表时间: 2021
• 影响因子: 3.9
• 作者: Wiggins, Kerri L;Floyd, James S;Bansal, Nisha;Kestenbaum, Bryan;Heckbert, Susan R
• 通讯作者: Heckbert, Susan R

Electrocardiographic markers of atrial cardiomyopathy and risk of heart failure in the multi-ethnic study of atherosclerosis (MESA) cohort.

动脉粥样硬化 (MESA) 队列多种族研究中心房心肌病的心电图标记物和心力衰竭风险。

• 发表时间: 2023
• 作者: Ahmad, Muhammad Imtiaz;Mujtaba, Mohammadtokir;Floyd, James S;Chen, Lin Y;Soliman, Elsayed Z
• 通讯作者: Soliman, Elsayed Z