Heart Rate at Rest and Incident Atrial Fibrillation in Patients With Diastolic Dysfunction
Diastolic dysfunction (DD) is associated with incident atrial fibrillation (AF). The influence of heart rate at rest (RHR) on incident AF in patients with DD has not been investigated. The goal of this study is to assess the influence of RHR on incident AF in patients with DD. Patients from a large...
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| Veröffentlicht in: | The American journal of cardiology 2024-05, Vol.218, p.72-76 |
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| creator | Preisendörfer, Stefan Singla, Virginia Bhonsale, Aditya Kancharla, Krishna Thoma, Floyd Mulukutla, Suresh Voigt, Andrew Shalaby, Alaa Estes, N.A. Mark Jain, Sandeep Saba, Samir |
| description | Diastolic dysfunction (DD) is associated with incident atrial fibrillation (AF). The influence of heart rate at rest (RHR) on incident AF in patients with DD has not been investigated. The goal of this study is to assess the influence of RHR on incident AF in patients with DD. Patients from a large health system with no previous history of AF, a left ventricular ejection fraction ≥50%, and documented DD on echocardiography were divided into quartiles (91 beats per minute) based on RHR. Incident AF was estimated using AF hospitalization during follow-up. Hazard ratios (HR) for AF hospitalization and all-cause death were calculated with a Cox proportional hazards model. A total of 19,046 patients were analyzed. Over a median follow-up of 42.2 months, 742 (3.9%) patients were hospitalized for AF. Both slower and faster RHR were associated with increased risk of AF hospitalization (HR 1.40, confidence interval [CI] 1.14 to 1.71, p = 0.001, HR 1.23, CI 0.99 to 1.53, p = 0.06 and HR 1.72, CI 1.38 to 2.14, p |
| doi_str_mv | 10.1016/j.amjcard.2024.03.005 |
| format | Article |
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Mark ; Jain, Sandeep ; Saba, Samir</creator><creatorcontrib>Preisendörfer, Stefan ; Singla, Virginia ; Bhonsale, Aditya ; Kancharla, Krishna ; Thoma, Floyd ; Mulukutla, Suresh ; Voigt, Andrew ; Shalaby, Alaa ; Estes, N.A. Mark ; Jain, Sandeep ; Saba, Samir</creatorcontrib><description>Diastolic dysfunction (DD) is associated with incident atrial fibrillation (AF). The influence of heart rate at rest (RHR) on incident AF in patients with DD has not been investigated. The goal of this study is to assess the influence of RHR on incident AF in patients with DD. Patients from a large health system with no previous history of AF, a left ventricular ejection fraction ≥50%, and documented DD on echocardiography were divided into quartiles (<66, 66 to 76, 77 to 91, >91 beats per minute) based on RHR. Incident AF was estimated using AF hospitalization during follow-up. Hazard ratios (HR) for AF hospitalization and all-cause death were calculated with a Cox proportional hazards model. A total of 19,046 patients were analyzed. Over a median follow-up of 42.2 months, 742 (3.9%) patients were hospitalized for AF. Both slower and faster RHR were associated with increased risk of AF hospitalization (HR 1.40, confidence interval [CI] 1.14 to 1.71, p = 0.001, HR 1.23, CI 0.99 to 1.53, p = 0.06 and HR 1.72, CI 1.38 to 2.14, p <0.001, for quartiles 1, 2, and 4, respectively), suggesting a J-shaped relation. Progressive increase in all-cause death was noted with faster RHR (HR1.19 per quartile increase, CI 1.16 to 1.22, p <0.001). These results persisted after adjustment for age, cardiovascular co-morbidities, grade of DD, and β-blocker use. In conclusion, this large, real-world analysis indicates increased risk of incident AF with slower and faster RHR in patients with DD. Randomized trials are needed to evaluate the potential of RHR modification to mitigate the risk of incident AF.</description><identifier>ISSN: 0002-9149</identifier><identifier>ISSN: 1879-1913</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2024.03.005</identifier><identifier>PMID: 38461926</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>all-cause mortality ; atrial fibrillation ; Cardiac arrhythmia ; Cardiovascular disease ; Clinical trials ; Coronary vessels ; Diabetes ; diastolic dysfunction ; Echocardiography ; Fibrillation ; Heart rate ; Hospitalization ; Hypertension ; Medical prognosis ; Mortality ; Patients ; Quartiles ; resting heart rate ; Risk factors ; Statistical models ; Vein & artery diseases</subject><ispartof>The American journal of cardiology, 2024-05, Vol.218, p.72-76</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><rights>2024. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c341t-818db7acd521308fa7a12936cfe606571d8286111e605398d976e849c5eb77bd3</cites><orcidid>0000-0003-4669-803X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914924001656$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38461926$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Preisendörfer, Stefan</creatorcontrib><creatorcontrib>Singla, Virginia</creatorcontrib><creatorcontrib>Bhonsale, Aditya</creatorcontrib><creatorcontrib>Kancharla, Krishna</creatorcontrib><creatorcontrib>Thoma, Floyd</creatorcontrib><creatorcontrib>Mulukutla, Suresh</creatorcontrib><creatorcontrib>Voigt, Andrew</creatorcontrib><creatorcontrib>Shalaby, Alaa</creatorcontrib><creatorcontrib>Estes, N.A. Mark</creatorcontrib><creatorcontrib>Jain, Sandeep</creatorcontrib><creatorcontrib>Saba, Samir</creatorcontrib><title>Heart Rate at Rest and Incident Atrial Fibrillation in Patients With Diastolic Dysfunction</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Diastolic dysfunction (DD) is associated with incident atrial fibrillation (AF). The influence of heart rate at rest (RHR) on incident AF in patients with DD has not been investigated. The goal of this study is to assess the influence of RHR on incident AF in patients with DD. Patients from a large health system with no previous history of AF, a left ventricular ejection fraction ≥50%, and documented DD on echocardiography were divided into quartiles (<66, 66 to 76, 77 to 91, >91 beats per minute) based on RHR. Incident AF was estimated using AF hospitalization during follow-up. Hazard ratios (HR) for AF hospitalization and all-cause death were calculated with a Cox proportional hazards model. A total of 19,046 patients were analyzed. Over a median follow-up of 42.2 months, 742 (3.9%) patients were hospitalized for AF. Both slower and faster RHR were associated with increased risk of AF hospitalization (HR 1.40, confidence interval [CI] 1.14 to 1.71, p = 0.001, HR 1.23, CI 0.99 to 1.53, p = 0.06 and HR 1.72, CI 1.38 to 2.14, p <0.001, for quartiles 1, 2, and 4, respectively), suggesting a J-shaped relation. Progressive increase in all-cause death was noted with faster RHR (HR1.19 per quartile increase, CI 1.16 to 1.22, p <0.001). These results persisted after adjustment for age, cardiovascular co-morbidities, grade of DD, and β-blocker use. In conclusion, this large, real-world analysis indicates increased risk of incident AF with slower and faster RHR in patients with DD. Randomized trials are needed to evaluate the potential of RHR modification to mitigate the risk of incident AF.</description><subject>all-cause mortality</subject><subject>atrial fibrillation</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Clinical trials</subject><subject>Coronary vessels</subject><subject>Diabetes</subject><subject>diastolic dysfunction</subject><subject>Echocardiography</subject><subject>Fibrillation</subject><subject>Heart rate</subject><subject>Hospitalization</subject><subject>Hypertension</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Patients</subject><subject>Quartiles</subject><subject>resting heart rate</subject><subject>Risk factors</subject><subject>Statistical models</subject><subject>Vein & artery diseases</subject><issn>0002-9149</issn><issn>1879-1913</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkMtq3DAUQEVpaSZJP6FF0E02dnUlS5ZWJUyaBwQSSkMgGyFLMpXx2KkkB_L31TCTLLLJ6uqic18Hoa9AaiAgfgy12QzWRFdTQpuasJoQ_gGtQLaqAgXsI1oRQmiloFEH6DCloaQAXHxGB0w2AhQVK_Rw6U3M-LfJHpsSfcrYTA5fTTY4P2V8mmMwIz4PXQzjaHKYJxwmfFte5Tvh-5D_4rNgUp7HYPHZc-qXyW6xY_SpN2PyX_bxCN2d__qzvqyuby6u1qfXlWUN5EqCdF1rrOMUGJG9aQ1QxYTtvSCCt-AklQIASsqZkk61wstGWe67tu0cO0Inu76Pcf63lAP0JiTry7KTn5ekqeKcinKvKuj3N-gwL3Eq22lGmGJUSdEUiu8oG-eUou_1YwwbE581EL2Vrwe9l6-38jVhusgvdd_23Zdu491r1YvtAvzcAb7oeAo-6mSLRetdiN5m7ebwzoj_ytKWTQ</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Preisendörfer, Stefan</creator><creator>Singla, Virginia</creator><creator>Bhonsale, Aditya</creator><creator>Kancharla, Krishna</creator><creator>Thoma, Floyd</creator><creator>Mulukutla, Suresh</creator><creator>Voigt, Andrew</creator><creator>Shalaby, Alaa</creator><creator>Estes, N.A. Mark</creator><creator>Jain, Sandeep</creator><creator>Saba, Samir</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4669-803X</orcidid></search><sort><creationdate>20240501</creationdate><title>Heart Rate at Rest and Incident Atrial Fibrillation in Patients With Diastolic Dysfunction</title><author>Preisendörfer, Stefan ; Singla, Virginia ; Bhonsale, Aditya ; Kancharla, Krishna ; Thoma, Floyd ; Mulukutla, Suresh ; Voigt, Andrew ; Shalaby, Alaa ; Estes, N.A. 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Mark</au><au>Jain, Sandeep</au><au>Saba, Samir</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Heart Rate at Rest and Incident Atrial Fibrillation in Patients With Diastolic Dysfunction</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>218</volume><spage>72</spage><epage>76</epage><pages>72-76</pages><issn>0002-9149</issn><issn>1879-1913</issn><eissn>1879-1913</eissn><abstract>Diastolic dysfunction (DD) is associated with incident atrial fibrillation (AF). The influence of heart rate at rest (RHR) on incident AF in patients with DD has not been investigated. The goal of this study is to assess the influence of RHR on incident AF in patients with DD. Patients from a large health system with no previous history of AF, a left ventricular ejection fraction ≥50%, and documented DD on echocardiography were divided into quartiles (<66, 66 to 76, 77 to 91, >91 beats per minute) based on RHR. Incident AF was estimated using AF hospitalization during follow-up. Hazard ratios (HR) for AF hospitalization and all-cause death were calculated with a Cox proportional hazards model. A total of 19,046 patients were analyzed. Over a median follow-up of 42.2 months, 742 (3.9%) patients were hospitalized for AF. Both slower and faster RHR were associated with increased risk of AF hospitalization (HR 1.40, confidence interval [CI] 1.14 to 1.71, p = 0.001, HR 1.23, CI 0.99 to 1.53, p = 0.06 and HR 1.72, CI 1.38 to 2.14, p <0.001, for quartiles 1, 2, and 4, respectively), suggesting a J-shaped relation. Progressive increase in all-cause death was noted with faster RHR (HR1.19 per quartile increase, CI 1.16 to 1.22, p <0.001). These results persisted after adjustment for age, cardiovascular co-morbidities, grade of DD, and β-blocker use. In conclusion, this large, real-world analysis indicates increased risk of incident AF with slower and faster RHR in patients with DD. Randomized trials are needed to evaluate the potential of RHR modification to mitigate the risk of incident AF.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38461926</pmid><doi>10.1016/j.amjcard.2024.03.005</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-4669-803X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | all-cause mortality atrial fibrillation Cardiac arrhythmia Cardiovascular disease Clinical trials Coronary vessels Diabetes diastolic dysfunction Echocardiography Fibrillation Heart rate Hospitalization Hypertension Medical prognosis Mortality Patients Quartiles resting heart rate Risk factors Statistical models Vein & artery diseases |
| title | Heart Rate at Rest and Incident Atrial Fibrillation in Patients With Diastolic Dysfunction |
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