Abstract 8854: Increased Carotid Intima-Media Thickness and Arterial Stiffness are Associated with Lone Atrial Fibrillation
Background Increased carotid intima-media thickness (cIMT) and pulse pressure are associated with common acquired atrial fibrillation (AF). It is unknown whether cIMT and indexes of arterial stiffness are associated with lone AF-onset of AF in patients <60 years in the absence of risk factors for AF. We sought to determine whether cIMT, arterial compliance (AC), carotid-femoral pulse wave velocity (CFPWV), and β stiffness index are associated with lone AF.
Methods Consecutive patients referred to the arrhythmia clinic for lone AF (onset <60 years) in the absence of hypertension, diabetes, and structural heart disease were included in the study. Patients <60 years seen in the general cardiology clinic without AF, hypertension, diabetes, and structural heart disease were included as controls. cIMT was measured by high resolution B-mode ultrasound. CFPWV was measured by applanation tonometry. AC and β stiffness index were measured using direct radiofrequency tracking of carotid artery pulsatility using Aloka eTracking software. All measurements were obtained during sinus rhythm. Multivariable logistic regression was used to assess association between lone AF and these exposures (modeled as quartiles): cIMT, AC, CFPWV, and β stiffness index.
Results We enrolled 133 lone AF cases (all variables presented as mean ± standard deviation - age at onset: 44.9 ± 10.6 years, cIMT: 0.68 ± 0.16 mm, AC: 0.73 ± 0.31 mm2/Kpa, CFPWV: 7.8 ± 1.8 m/s, β stiffness index: 10.9 ± 4.4) and 171 controls (age at enrollment: 46.7 ± 9.4years, cIMT: 0.61 ± 0.13 mm, AC: 0.84 ± 0.30 mm2/Kpa, CFPWV: 7.1 ± 1.3 m/s, β stiffness index: 8.6 ± 3.1). In multivariable logistic regression analyses, cIMT (OR, 1.6 per quartile increment; 95% CI, 1.2 to 2.1; p=0.002), AC (OR, 0.7 per quartile increment; 95% CI, 0.5 to 0.9; p=0.004), CFPWV (OR, 1.4 per quartile increment; 95% CI, 1.1 to 1.8; p=0.02), and β stiffness index (OR, 1.7 per quartile increment; 95% CI, 1.3 to 2.4; p=0.0005) were found to be associated with lone AF after adjusting for age, gender, and left atrial volume index.
Conclusions Increased cIMT and arterial stiffness are associated with lone AF. Lone AF is not only an ‘electrical disease’. Morphological and functional changes in the arteries may increase risk of lone AF, as in common acquired AF.
- © 2011 by American Heart Association, Inc.