Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 50, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Department of Medical Informatics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Europace. 2023 Jun 2;25(6). doi: 10.1093/europace/euad164.
We aimed to assess the (shape of the) association and sex differences in the link between electrocardiographic parameters and new-onset atrial fibrillation (AF).
A total of 12 212 participants free of AF at baseline from the population-based Rotterdam Study were included. Up to five repeated measurements of electrocardiographic parameters including PR, QRS, QT, QT corrected for heart rate (QTc), JT, RR interval, and heart rate were assessed at baseline and follow-up examinations. Cox proportional hazards- and joint models, adjusted for cardiovascular risk factors, were used to determine the (shape of the) association between baseline and longitudinal electrocardiographic parameters with new-onset AF. Additionally, we evaluated potential sex differences. During a median follow-up of 9.3 years, 1282 incident AF cases occurred among 12 212 participants (mean age 64.9 years, 58.2% women). Penalized cubic splines revealed that associations between baseline electrocardiographic measures and risk of new-onset AF were generally U- and N-shaped. Sex differences in terms of the shape of the various associations were most apparent for baseline PR, QT, QTc, RR interval, and heart rate in relation to new-onset AF. Longitudinal measures of higher PR interval [fully adjusted hazard ratio (HR), 95% confidence interval (CI), 1.43, 1.02-2.04, P = 0.0393] and higher QTc interval (fully adjusted HR, 95% CI, 5.23, 2.18-12.45, P = 0.0002) were significantly associated with new-onset AF, in particular in men.
Associations of baseline electrocardiographic measures and risk of new-onset AF were mostly U- and N-shaped. Longitudinal electrocardiographic measures of PR and QTc interval were significantly associated with new-onset AF, in particular among men.
评估心电图参数与新发心房颤动（AF）之间的关联和性别差异。
本研究共纳入了来自人群基础的鹿特丹研究的 12212 名基线时无 AF 的参与者。在基线和随访检查时评估了心电图参数（包括 PR、QRS、QT、心率校正的 QT（QTc）、JT、RR 间隔和心率）的多达 5 次重复测量。使用 Cox 比例风险和联合模型，调整心血管危险因素，确定基线和纵向心电图参数与新发 AF 之间的（形状的）关联。此外，我们评估了潜在的性别差异。在中位随访 9.3 年期间，12212 名参与者中发生了 1282 例新发 AF 病例（平均年龄 64.9 岁，58.2%为女性）。惩罚三次样条显示，基线心电图测量与新发 AF 风险之间的关联一般呈 U 形和 N 形。基线 PR、QT、QTc、RR 间隔和心率与新发 AF 相关的各种关联的形状方面的性别差异最为明显。较高的 PR 间隔（完全调整后的危险比[HR]，95%置信区间[CI]，1.43，1.02-2.04，P=0.0393）和较高的 QTc 间隔（完全调整后的 HR，95%CI，5.23，2.18-12.45，P=0.0002）的纵向测量与新发 AF 显著相关，尤其是在男性中。
基线心电图测量与新发 AF 风险的关联大多呈 U 形和 N 形。PR 和 QTc 间隔的纵向心电图测量与新发 AF 显著相关，尤其是在男性中。
