Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
Lillehei Heart Institute, University of Minnesota Medical School, Minneapolis, MN, USA.
Hypertens Res. 2024 Oct;47(10):2902-2913. doi: 10.1038/s41440-024-01831-3. Epub 2024 Aug 8.
Atrial myopathy-defined as abnormal left atrial (LA) size and function-is associated with an increased risk of atrial fibrillation, heart failure, and dementia. Central arterial stiffness is associated with increased atrial afterload and fibrosis and may be a risk factor for atrial myopathy. We examined the association of carotid-femoral pulse wave velocity (cfPWV) with LA function and assessed potential causal relationships. We included 2825 Atherosclerosis Risk in Communities (ARIC) study participants from Visit 5 (2011-2013). cfPWV was related to echocardiographic LA function continuously per 1-SD and categorically in quartiles. Mendelian randomization (MR) analysis was performed using U.K. Biobank-derived genetic variants associated with arterial stiffness index and cardiac magnetic resonance measures of LA function. When analyzed per SD increment (297.6 cm/s), higher cfPWV was significantly associated with lower LA reservoir and conduit strain (β = -0.53%, 95% CI [-0.81, -0.25] and β = -0.46%, 95% CI [-0.68, -0.25], respectively) after adjusting for demographics, clinical characteristics, systolic blood pressure, and left ventricular (LV) morphology and function. In MR analyses there was a non-significant inverse association of arterial stiffness index with LA total, passive, and active emptying fractions. Higher cfPWV is associated with lower LA reservoir and conduit strain, independent of systolic blood pressure and LV morphology and function. No evidence for a causal relationship between arterial stiffness index and alterations in LA function was found. Future studies should examine the prospective association of central arterial stiffness with LA function alterations.
心房肌病定义为左心房（LA）大小和功能异常，与心房颤动、心力衰竭和痴呆的风险增加相关。中心动脉僵硬与心房后负荷增加和纤维化相关，可能是心房肌病的一个危险因素。我们研究了颈动脉-股动脉脉搏波速度（cfPWV）与 LA 功能的相关性，并评估了潜在的因果关系。我们纳入了 2825 名来自访问 5 期（2011-2013 年）的动脉粥样硬化风险社区（ARIC）研究参与者。cfPWV 与超声心动图 LA 功能连续每 1-SD 以及四分类相关。使用英国生物库中与动脉僵硬指数和 LA 功能的心脏磁共振测量相关的遗传变异进行孟德尔随机分析。当按 SD 增量（297.6 cm/s）分析时，较高的 cfPWV 与较低的 LA 储备和传导应变显著相关（β=-0.53%，95%CI[-0.81，-0.25]和β=-0.46%，95%CI[-0.68，-0.25]），校正后包括人口统计学、临床特征、收缩压和左心室（LV）形态和功能。在 MR 分析中，动脉僵硬指数与 LA 总、被动和主动排空分数呈负相关，但无统计学意义。较高的 cfPWV 与较低的 LA 储备和传导应变相关，独立于收缩压和 LV 形态和功能。没有证据表明动脉僵硬指数与 LA 功能改变之间存在因果关系。未来的研究应该检查中心动脉僵硬与 LA 功能改变的前瞻性关联。
