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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 182] [Impact Index Per Article: 182.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Badura K, Buławska D, Dąbek B, Witkowska A, Lisińska W, Radzioch E, Skwira S, Młynarska E, Rysz J, Franczyk B. Primary Electrical Heart Disease-Principles of Pathophysiology and Genetics. Int J Mol Sci 2024; 25:1826. [PMID: 38339103 PMCID: PMC10855675 DOI: 10.3390/ijms25031826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
Primary electrical heart diseases, often considered channelopathies, are inherited genetic abnormalities of cardiomyocyte electrical behavior carrying the risk of malignant arrhythmias leading to sudden cardiac death (SCD). Approximately 54% of sudden, unexpected deaths in individuals under the age of 35 do not exhibit signs of structural heart disease during autopsy, suggesting the potential significance of channelopathies in this group of age. Channelopathies constitute a highly heterogenous group comprising various diseases such as long QT syndrome (LQTS), short QT syndrome (SQTS), idiopathic ventricular fibrillation (IVF), Brugada syndrome (BrS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and early repolarization syndromes (ERS). Although new advances in the diagnostic process of channelopathies have been made, the link between a disease and sudden cardiac death remains not fully explained. Evolving data in electrophysiology and genetic testing suggest previously described diseases as complex with multiple underlying genes and a high variety of factors associated with SCD in channelopathies. This review summarizes available, well-established information about channelopathy pathogenesis, genetic basics, and molecular aspects relative to principles of the pathophysiology of arrhythmia. In addition, general information about diagnostic approaches and management is presented. Analyzing principles of channelopathies and their underlying causes improves the understanding of genetic and molecular basics that may assist general research and improve SCD prevention.
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Affiliation(s)
- Krzysztof Badura
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland (S.S.)
| | - Dominika Buławska
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland (S.S.)
| | - Bartłomiej Dąbek
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland (S.S.)
| | - Alicja Witkowska
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland (S.S.)
| | - Wiktoria Lisińska
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland (S.S.)
| | - Ewa Radzioch
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland (S.S.)
| | - Sylwia Skwira
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland (S.S.)
| | - Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland (S.S.)
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland (S.S.)
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1460] [Impact Index Per Article: 1460.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, Charron P, Corrado D, Dagres N, de Chillou C, Eckardt L, Friede T, Haugaa KH, Hocini M, Lambiase PD, Marijon E, Merino JL, Peichl P, Priori SG, Reichlin T, Schulz-Menger J, Sticherling C, Tzeis S, Verstrael A, Volterrani M. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 2022; 43:3997-4126. [PMID: 36017572 DOI: 10.1093/eurheartj/ehac262] [Citation(s) in RCA: 890] [Impact Index Per Article: 445.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Is waist-to-height ratio the best predictive indicator of cardiovascular disease incidence in hypertensive adults? A cohort study. BMC Cardiovasc Disord 2022; 22:214. [PMID: 35545759 PMCID: PMC9092683 DOI: 10.1186/s12872-022-02646-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 04/20/2022] [Indexed: 12/11/2022] Open
Abstract
Background Cardiovascular disease (CVD) brings high mortality and economic burden to patients, especially in rural areas. Simple, low-cost abdominal adiposity measures may help identify individuals with increased CVD risk. It is unclear that which obesity indices is the best to predict CVD in hypertensive people. Methods Northeast China Rural Cardiovascular Health Study (NCRCHS) is a prospective cohort study in a general population in Northeast China. The study examined the cardiovascular health from 2013 to 2015, and follow-up captured the CVD incidence in 2018. Baseline waist-to-height ratio (WHtR), waist circumference (WC), waist-to-hip (WHR)and body mass index (BMI) were calculated and analyzed in relation to the CVD incidence. Results A total of 4244 hypertensive adults without pre-existing CVD at baseline were included in this analysis (age 35–92 years; 2108 men). Over a median follow-up of 4.66 years, a total of 290 CVD cases (6.83%) were documented during the follow-up. Baseline WHtR showed a significant positive association with CVD incidence, even after adjusting for age, sex, diabetes, drinking, smoking, SBP, DBP, Triglyceride, HDL-C, LDL-C, and TC (Hazard Ratios per SD of WHtR ranging from 1.03 to 1.31, p = 0.017). Reclassification and discrimination analyses indicated WHtR addition could improve the conventional model for predicting adverse outcomes within 4 years. Moreover, WHtR predicted the CVD incidence better than other obesity indices (BMI, WC, WHR). Conclusion These findings support a positive association between WHtR and CVD incidence in CVD-free hypertensive adults. WHtR can be used to predict CVD incidence in hypertensive adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02646-1.
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Krishnan MN, Geevar Z, Venugopal KN, Mohanan PP, Harikrishnan S, Sanjay G, Devika S, Thankappan KR. A community-based study on electrocardiographic abnormalities of adult population from South India - findings from a cross sectional survey. Indian Heart J 2022; 74:187-193. [PMID: 35576992 PMCID: PMC9243607 DOI: 10.1016/j.ihj.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/10/2022] [Accepted: 05/08/2022] [Indexed: 11/29/2022] Open
Abstract
Background There are no data on electrocardiographic (ECG) findings from general population of Indian subcontinent. We analyzed ECG abnormalities of in adults as part of a community survey of prevalence of coronary artery disease and risk factors from South India. Methods and results In this cross-sectional study of men and women between the ages 20 to 79 years, ECGs recorded digitally were analyzed using the Minnesota code. Electrocardiograms were analyzed for abnormalities in 4630 participants (women 59.6%). The overall prevalence of ECG abnormalities (39.9%) was higher in men (47.24% vs. 34.9% p <0.0001). QRS axis deviation, first degree AV block, fascicular blocks, incomplete right bundle branch block, sinus bradycardia and ST elevation in the anterior chest leads were markedly higher in men. Sinus tachycardia and low voltage QRS occurred more often in women. The overall prevalence of atrial fibrillation was 0.32% which was markedly lower than the western data. Brugada and early repolarisation patterns occurred in 1.06% and 1.56% respectively, equal in both age groups, but markedly higher in men. Brugada pattern occurred more often than in the west, but much less than the Far East population. Early repolarisation pattern was similar to rest of Asian population, but significantly less than the Caucasian population Conclusion In this community-based study, prevalence of major electrocardiographic abnormalities was high. Overall, men had significantly higher ECG abnormalities.
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Affiliation(s)
| | | | | | | | | | - Ganapathi Sanjay
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
| | | | - Kavumpurathu Raman Thankappan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum Medical College, P.O., Thiruvananthapuram, Kerala, India.
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2629] [Impact Index Per Article: 1314.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Ji HY, Hu N, Liu R, Zhou HR, Gao WL, Quan XQ. Worldwide prevalence of early repolarization pattern in general population and physically active individuals: A meta-analysis. Medicine (Baltimore) 2021; 100:e25978. [PMID: 34087840 PMCID: PMC8183793 DOI: 10.1097/md.0000000000025978] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/28/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The early repolarization pattern (ERP) has recently been associated with cardiac events such as ventricular arrhythmias and sudden cardiac death. However, estimates of the prevalence of ERP vary widely, especially between the general population and physically active individuals. We performed this systematic review and meta-analysis to quantitatively evaluate the worldwide prevalence of ERP in the general population and physically active individuals. METHODS We thoroughly searched the PubMed, EMBASE, Web of science, the Cochrane Library, and Scopus databases for relevant studies published until December 20, 2020. Studies in which prevalence was presented or could be estimated from eligible data were included. The pooled prevalence was analyzed using a random-effect model. RESULTS Finally, we included 29 studies (182,135 subjects) in the general population and 14 studies (8087 subjects) in the physically active individuals. The worldwide pooled prevalence of ERP in the general population was 11.6% (95% confidence interval [CI]: 10.0%-13.3%). The incidence of ERP was 17.0% and 6.2% in men and women, respectively. The prevalence was 20.9% in blacks, 13.4% in Asians, and 10.1% in Caucasians. Additionally, the prevalence of ERP in physically active individuals was 33.9% (95% CI: 25.3%-42.6%). CONCLUSION A significant difference in the worldwide prevalence of ERP is revealed in this study. The ERP is highly prevalent in men, blacks, and physically active individuals.
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Affiliation(s)
| | | | - Rui Liu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Hai-Rong Zhou
- Department of General Practice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
| | - Wei-Liang Gao
- Department of General Practice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
| | - Xiao-Qing Quan
- Department of General Practice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
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Complementary value of ECG and echocardiographic left ventricular hypertrophy for prediction of adverse outcomes in the general population. J Hypertens 2021; 39:548-555. [PMID: 33543885 DOI: 10.1097/hjh.0000000000002652] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate whether ECG left ventricular hypertrophy (ECG-LVH) has prognostic value independent of echocardiography LVH (Echo-LVH). METHODS Participants (N = 9744, mean age, 53.81 ± 10.49 years and 45.5% male) from the Northeast China Rural Cardiovascular Health Study were included. Associations between Echo-LVH (sex-specific left ventricular mass normalized to BSA) and ECG-LVH (diagnosed using the Cornell-voltage duration product) and adverse outcomes were evaluated using Cox regression. The value of ECG-LVH for predicting adverse events was evaluated by reclassification and discrimination analyses. RESULTS Median follow-up was 4.65 years; 563 participants developed incident stroke or coronary heart disease (CHD) and 402 died. Compared with participants without either condition, those with both Echo-LVH and ECG-LVH had a significantly increased risk of incident stroke or CHD (hazard ratio, 2.42; 95% confidence interval, 1.82-3.22) and mortality (2.58; 1.85-3.60). ECG-LVH remained an independent risk factors for both outcomes when ECG-LVH and Echo-LVH were included in the model as separate variables [incident stroke or CHD (1.43; 1.14-1.79); mortality (1.41; 1.08-1.84)]. Reclassification and discrimination analyses indicated ECG-LVH addition could improve the conventional model for predicting adverse outcomes within 4 years. These relationships persisted after excluding participants with cardiovascular disease history or taking antihypertension drugs or upon applying other ECG-LVH and Echo-LVH diagnostic criteria. CONCLUSION Our study provides strong evidence that ECG-LVH is associated with adverse outcomes, independent of Echo-LVH. Clinically, ECG-LVH could be considered as a consequential factor, especially in those with Echo-LVH. These findings have potential clinical relevance for risk stratification.
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Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 3176] [Impact Index Per Article: 1058.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Matta MG, Gulayin PE, García-Zamora S, Gutierrez L, Rubinstein AL, Irazola VE, Poggio R, Gonzalez-Zuelgaray J. Epidemiology of early repolarization pattern in an adult general population. Acta Cardiol 2020; 75:713-723. [PMID: 31526309 DOI: 10.1080/00015385.2019.1667623] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background: Early repolarization pattern (ERP) is a frequent finding in asymptomatic subjects with controversial implications regarding to its prognosis. This study aims to estimate the prevalence of ERP and its association with sociodemographic characteristics and cardiovascular risk factors among the adult population in the Southern Cone of Latin America.Methods: A sub-sample of 5398 participants of the CESCAS I study was included in the present analysis. ERP was defined as a J peak ≥0.1 mV in two or more contiguous leads with an end-QRS notch or slur on the downslope of a prominent R-wave.Results: The global prevalence of ERP was 8.1%; 11.1% in men and 5.6% in women. The prevalence in women increased with age (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.5-4.2, at >65 years, p < 0.001), current cigarette smoking (OR 1.4, 95%CI 1.0-2.0, p = 0.045) and hypercholesterolaemia (OR 1.4, 95%CI 1.0-2.0, 0 p = 0.036). Conversely, in men, ERP prevalence decreased with age (OR 0.5, 95%CI 0.3-0.9, at >65 years, p = 0.01) and obesity (OR 0.6, 95%CI 0.4-0.8, p = 0.006). We found an increasing ERP prevalence with a higher Sokolow-Lyon index in both sexes (p < 0.001). Inferior location was found in 67.9% of cases, and the most common ERP type was a "slurring" appearance without ST elevation (76.3%).Conclusions: We found an overall prevalence of ERP of 8.1% and a robust association of ERP with normal BMI and higher Sokolow-Lyon index in men and with hypercholesterolaemia, current cigarette smoking and higher Sokolow-Lyon index in women.
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Affiliation(s)
- María Gabriela Matta
- South American Center of Excellence for Cardiovascular Health (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Pablo Elias Gulayin
- South American Center of Excellence for Cardiovascular Health (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Sebastián García-Zamora
- South American Center of Excellence for Cardiovascular Health (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Laura Gutierrez
- South American Center of Excellence for Cardiovascular Health (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | | | - Vilma Edith Irazola
- South American Center of Excellence for Cardiovascular Health (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Rosana Poggio
- South American Center of Excellence for Cardiovascular Health (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Jorge Gonzalez-Zuelgaray
- Institute of Cardiological Research, University of Buenos Aires-CONICET, Buenos Aires, Argentina
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Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141:e139-e596. [PMID: 31992061 DOI: 10.1161/cir.0000000000000757] [Citation(s) in RCA: 4939] [Impact Index Per Article: 1234.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals. RESULTS Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Ye N, Sun GZ, Zhou Y, Wu SJ, Sun YX. Influence of relative wall thickness on electrocardiographic voltage measures in left ventricular hypertrophy: a novel factor contributing to poor diagnostic accuracy. Postgrad Med 2020; 132:141-147. [PMID: 31900004 DOI: 10.1080/00325481.2019.1702799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To characterize the influence of relative wall thickness (RWT) on Cornell, Sokolow-Lyon and Peguero-Lo Presti voltages and elucidate its potential impacts on their diagnostic accuracy for LVH in a large general Chinese population.Methods: A total of 10,614 permanent residents aged ≥ 35 years were recruited for this study. All the participants were subjected to ECG and echocardiogram during the same visit. Multivariate linear and logistic regression analyzes were conducted to assess the influence of RWT on the voltages and their diagnostic performance for LVH detection.Results: A distinct correlation was identified between RWT and Cornell and Peguero-Lo Presti voltages following adjustments for age, gender and left ventricular mass (LVM) (β = 0.675 and 1.342, respectively; Ps < 0.001). Besides, subjects with RWT > 0.42 exhibited higher rates of LVH diagnosed by Cornell (OR = 1.78, 95% CI: 1.45-2.20), Sokolow-Lyon (OR = 1.30, 95% CI: 1.08-1.56), and Peguero-Lo Presti voltage (OR = 1.48, 95% CI: 1.29-1.70) after adjustments for age, gender and echocardiographic LVH. Furthermore, concentric remodeling or concentric hypertrophy displayed higher rates of LVH diagnoses via Cornell and Peguero-Lo Presti voltage criteria, as compared with normal geometry or eccentric hypertrophy, respectively (all Ps < 0.05), findings of which were independent of age, gender and LVMI.Conclusion: Echocardiographic RWT was independently correlated with electrocardiographic voltage measures of LVH, which influenced their positive rates and contributed to poor diagnostic performance.
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Affiliation(s)
- Ning Ye
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Guo-Zhe Sun
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ying Zhou
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shao-Jun Wu
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ying-Xian Sun
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
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Leiderman E, Kargoli F, Shulman E, Aagaard P, Hoch E, Zaremski L, Di Biase L, Kim SG, Gross JN, Ferrick KJ, Fisher J, Krumerman A. Early repolarization pattern in an ethnically diverse population: Increased risk in Hispanics. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2019; 43:30-36. [DOI: 10.1111/pace.13827] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/17/2019] [Accepted: 10/04/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Ephraim Leiderman
- Division of Internal Medicine, Department of MedicineJacobi Medical Center Bronx New York
| | - Faraj Kargoli
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
| | - Eric Shulman
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
| | - Philip Aagaard
- Division of CardiologyCleveland Clinic Foundation Cleveland Ohio
| | - Ethan Hoch
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
| | - Lynn Zaremski
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
| | - Luigi Di Biase
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
- Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin Texas
- Department of Biomedical EngineeringUniversity of Texas Austin Texas
- Department of CardiologyUniversity of Foggia Foggia Italy
| | - Soo G. Kim
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
| | - Jay N. Gross
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
| | - Kevin J. Ferrick
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
| | - John Fisher
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
| | - Andrew Krumerman
- Division of Cardiology, Department of MedicineMontefiore Medical Center Bronx New York
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Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O'Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019; 139:e56-e528. [PMID: 30700139 DOI: 10.1161/cir.0000000000000659] [Citation(s) in RCA: 5401] [Impact Index Per Article: 1080.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Independent Influence of Blood Pressure on QTc Interval: Results from a General Chinese Population. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1656123. [PMID: 31360702 PMCID: PMC6644263 DOI: 10.1155/2019/1656123] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/02/2019] [Indexed: 11/28/2022]
Abstract
Aims We performed the current study primarily to characterize the independent association of blood pressure with heart rate-corrected QT (QTc) interval after adjusting for cardiovascular confounding factors and left ventricular mass (LVM) in a large general population in China. Methods All enrolled 10,553 permanent residents with age ≥ 35 years from Liaoning Province were investigated by a questionnaire and then subjected to physical examinations, laboratory analyses, and electrocardiogram (ECG) as well as echocardiogram at the same visit. Multivariate linear and logistic regression analyses were conducted to assess the independent association of blood pressure with QTc interval. Results Hypertensive subjects had significantly longer QTc interval and higher prevalence of prolonged QTc interval compared with normotensive ones in all subgroups stratified by gender and left ventricular hypertrophy (LVH) (all Ps ≤ 0.001). Multiple relevant clinical confounding factors and LVM were all adjusted in the multivariate linear and logistic regression analyses. As a result, both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were independently associated with QTc interval (β = 0.12 and 0.16, respectively; Ps < 0.001). Furthermore, as categorical variables, hypertension was independently associated with prolonged QTc interval (OR = 1.71; P < 0.001). Sex-specific analyses revealed that the independent associations were detected in both males and females (all Ps < 0.001). Conclusions These key findings of the current study highlighted the fact that hypertension was significantly associated with prolonged QTc interval and the correlations were independent of confounding factors and LVM.
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Wang H, Wang S, Sun G, Chen Y, Sun Y. Could subclinical organ damage markers improve atherosclerotic cardiovascular disease risk assessment in general Chinese population? Int J Cardiol 2018; 268:229. [DOI: 10.1016/j.ijcard.2018.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 03/02/2018] [Indexed: 11/16/2022]
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Wang H, Wang S, Yi X, Tao Y, Qian H, Jia P, Chen Y, Sun Y. Estimate of ischemic stroke prevalence according to a novel 4-tiered classification of left ventricular hypertrophy: insights from the general Chinese population. Ann Med 2018; 50:519-528. [PMID: 30001637 DOI: 10.1080/07853890.2018.1500702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Recently, a novel 4-tiered classification of left ventricular hypertrophy (LVH) based on ventricular dilatation (indexed LV end-diastolic volume [EDV]) and concentricity (mass/EDV0.67) has improved all-cause and cardiovascular mortality risk stratification. However, their possible association with ischemic stroke has not been extensively evaluated in the general population. METHODS We evaluated a cross-sectional study of 11,037 subjects from the general population of China in whom echocardiographic and ischemic stroke data were available to subdivide patients with LVH into four geometric patterns: indeterminate, dilated, thick and both thick and dilated hypertrophy. RESULTS Compared with normal LV geometry, indeterminate and thick hypertrophy showed a higher prevalence of ischemic stroke (p < .05). Ischemic stroke was significantly greater in participants with indeterminate (adjusted odd ratio [OR]:1.635, 95% confidence interval [CI]: 1.115-2.398) and thick (2.143 [1.329-3.456]) hypertrophy but not significantly in those with dilated (1.251 [0.803-1.950]) and both thick and dilated hypertrophy (0.926 [0.435-1.971]) compared with normal geometry in multivariable analysis. CONCLUSIONS Indeterminate and thick hypertrophy were significantly associated with the presence of ischemic stroke in the general Chinese population. The new 4-tiered categorization of LVH can permit a better understanding of which subjects are at high enough risk for ischemic stroke to warrant early targeted therapy. Key messages This was the first study to investigate whether a 4-tiered classification of LVH defines subgroups in the general population that are at variable risks of ischemic stroke. We identified that thick hypertrophy carried the greatest odd for ischemic stroke, independently of traditional risk factors, followed by indeterminate hypertrophy. The new 4-tiered categorization of LVH emerged as a valuable operational approach, a potential alternative to LVM, to refine ischemic stroke stratification in general population.
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Affiliation(s)
- Haoyu Wang
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , China
| | - Shuze Wang
- b Department of Computational Medicine and Bioinformatics , University of Michigan , Ann Arbor , MI , USA
| | - Xin Yi
- c Department of Cardiovascular Medicine , Beijing Moslem Hospital , Beijing , China
| | - Yining Tao
- d Department of Radiology , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Hao Qian
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , China
| | - Pengyu Jia
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , China
| | - Yintao Chen
- e Department of Cardiovascular Medicine , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Yingxian Sun
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , China
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Sun GZ, Wang HY, Chen YT, Sun YX. Serum uric acid levels positively correlates with 10-year cardiovascular risk score in the general population from China. Int J Cardiol 2018; 266:259. [DOI: 10.1016/j.ijcard.2018.01.086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 01/19/2018] [Indexed: 10/14/2022]
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Yao H, Fan J, Cheng YJ, Chen XM, Ji CC, Liu LJ, Zheng ZH, Wu SH. SCN1Bβ mutations that affect their association with Kv4.3 underlie early repolarization syndrome. J Cell Mol Med 2018; 22:5639-5647. [PMID: 30160358 PMCID: PMC6201368 DOI: 10.1111/jcmm.13839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/13/2018] [Indexed: 12/12/2022] Open
Abstract
Background Abnormal cardiac ion channels current, including transient outward potassium current (Ito), is associated with early repolarization syndrome (ERS). Previous studies showed that mutations in SCN1Bβ both to increase the Ito current and to decrease the sodium current. Yet its role in ERS remains unknown. Objective To determine the role of mutations in the SCN1Bβ subunits in ERS. Methods We screened for mutations in the SCN1B genes from four families with ERS. Wild‐type and mutant SCN1Bβ genes were co‐expressed with wild‐type KCND3 in human embryonic kidney cells (HEK293). Whole‐cell patch‐clamp technique and co‐immunoprecipitation were used to study the electrophysiological properties and explore the underlying mechanisms. Results S248R and R250T mutations in SCN1Bβ were detected in 4 families’ probands. Neither S248R nor R250T mutation had significant influence on the sodium channel current density (INa) when co‐expressed with SCN5A/WT. Co‐expression of KCND3/WT and SCN1Bβ/S248R or SCN1Bβ/R250T increased the transient outward potassium current Ito by 27.44% and 199.89%, respectively (P < 0.05 and P < 0.01, respectively) when compared with SCN1Bβ/WT. Electrophysiological properties showed that S248R and R250T mutations decreased the steady‐state inactivation and recovery from inactivation of Ito channel. Co‐immunoprecipitation study demonstrated an increased association between SCN1Bβ mutations and Kv4.3 compared with SCN1Bβ/WT (P < 0.05 and P < 0.01, respectively). Conclusion The S248R and R250T mutations of SCN1Bβ gene caused gain‐of‐function of Ito by associated with Kv4.3, which maybe underlie the ERS phenotype of the probands.
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Affiliation(s)
- Hao Yao
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, NHC, Guangzhou, China
| | - Jun Fan
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, NHC, Guangzhou, China
| | - Yun-Jiu Cheng
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, NHC, Guangzhou, China
| | - Xu-Miao Chen
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, NHC, Guangzhou, China
| | - Cheng-Cheng Ji
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, NHC, Guangzhou, China
| | - Li-Juan Liu
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, NHC, Guangzhou, China
| | - Zi-Heng Zheng
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, NHC, Guangzhou, China
| | - Su-Hua Wu
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on Assisted Circulation, NHC, Guangzhou, China
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Chen Y, Guo X, Sun G, Li Z, Zheng L, Sun Y. Effect of serum electrolytes within normal ranges on QTc prolongation: a cross-sectional study in a Chinese rural general population. BMC Cardiovasc Disord 2018; 18:175. [PMID: 30157775 PMCID: PMC6114040 DOI: 10.1186/s12872-018-0906-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/09/2018] [Indexed: 01/10/2023] Open
Abstract
Background Many previous clinical studies have reported that prolongation of the QT interval corrected for heart rate (QTc) is associated with an increased risk of sudden cardiac death and all-cause mortality. This study aimed to explore associations between serum electrolytes and QTc prolongation in the north-eastern Chinese rural general population. Methods We performed a cross-sectional study including 10,334 (4820 men and 5514 women) from the general population aged ≥35 years in the Liaoning Province from 2012 to 2013. Anthropometric measurements, laboratory examinations and self-reported lifestyle factor information, echocardiography and electrocardiogram were collected by trained personnel. The associations between serum electrolytes and QTc prolongation were tested using multiple linear regression and logistic regression analyses. Results The mean QTc interval were 415.6 ± 18.8 and 470.1 ± 23.1 ms in normal group and QTc prolongation group respectively. The prevalence of QTc prolongation increased significantly with a decrease in serum potassium and an increase in magnesium. Stepwise multiple linear regression showed that age, hypertension, waist circumference were prominently positive associated with QTc interval both in male and female population. But serum potassium was significantly inversely associated with QTc interval. Serum magnesium and calcium also showed a positive relationship with QTc interval. Furthermore, multiple logistic regression found that lower quartile of serum potassium had higher risk for QTc prolongation, especially in female population (Q2 vs. Q4: OR: 1.54, 95%CI: 1.01–2.35; Q1 vs. Q4: OR: 2.02, 95%CI: 1.36–3.01). In addition, the higher serum magnesium increased the risk of QTc prolongation, which was significantly only in male population. Conclusions In present Chinese rural general population, even with normal range, a decrease in serum potassium and an increase in serum magnesium are important risk factors for QTc prolongation. Electronic supplementary material The online version of this article (10.1186/s12872-018-0906-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yintao Chen
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China.
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Is diabetes correlating with small aortic root dimension in general Chinese hypertensive patients? Int J Cardiol 2018; 264:189. [DOI: 10.1016/j.ijcard.2018.02.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 02/22/2018] [Indexed: 11/23/2022]
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Nardi E, Mulè G, Nardi C, Geraci G, Averna M. Diabetes and aortic root dimension: A controversial subject. Int J Cardiol 2018; 264:190. [DOI: 10.1016/j.ijcard.2018.03.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/14/2018] [Indexed: 11/26/2022]
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Sun GZ, Wang HY, Zhou Y, Sun YX. Low prevalence of inter-atrial block in the general population from China: A possible reason for its low rates of atrial fibrillation. Int J Cardiol 2018; 260:111. [PMID: 29622421 DOI: 10.1016/j.ijcard.2018.02.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/14/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Guo-Zhe Sun
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Hao-Yu Wang
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Ying Zhou
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Ying-Xian Sun
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China.
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Roche NC, Massoure PL, Deharo JC, Paule P, Fourcade L. Seven years follow-up of early repolarisation patterns in French elite special forces. Ann Noninvasive Electrocardiol 2018; 23:e12560. [PMID: 29856088 DOI: 10.1111/anec.12560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 04/13/2018] [Accepted: 04/13/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The early repolarization pattern (ERP) may be a marker of increased risk for sudden cardiac death (SCD). Influence of ethnicity on the ERP has not been extensively studied. The aim of this study was to evaluate the epidemiology of ERP in a male multiethnic population. METHODS ECG analysis was performed among consecutive recruits from the French Foreign Legion. ERP was characterized by a J-point elevation ≥0.1 mV in two continuous inferior-lateral leads, and high amplitude early repolarization (HAER-potentially malignant pattern) by an elevation ≥0.2 mV. Ethnical affiliation and level of physical activity were recorded. RESULTS A total of 2508 healthy men (24 ± 5 years old) from 105 different native countries were divided into three ethnic groups: 1689 Whites, 388 Afro-Caribbean, and 431 Asians. ERP was found in 489 recruits (19%), 14% in Whites, 33% in Afro-Caribbeans, and 27% in Asians without any difference according to age and physical activity. Sub-Saharan Africans or Caribbeans had the highest rate of ERP (30%), and Hispanics the lowest (8%). People from occidental countries, Middle East, Central Asia or India had a rate of 12%-18%, East and South-Asia 20%-25%. Madagascar was an exception with only 16% of ERP. HAER (2.9%) was more frequent among Asian recruits. After 5 ± 2 years of follow up, one SCD occurred in the ERP group (p = 0.042). CONCLUSION This study reports a large multiethnic analysis of ERP. HAER was more frequent in recruits from East and South-East Asia where sudden unexplained nocturnal death syndrome is endemic.
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Affiliation(s)
- Nicolas-Charles Roche
- Department of Cardiology, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France
| | | | - Jean-Claude Deharo
- Department of Rhythmology, Hôpital Universitaire La Timone, Marseille, France
| | - Philippe Paule
- Department of Cardiology, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France
| | - Laurent Fourcade
- Department of Cardiology, Hôpital d'Instruction des Armées Laveran, Marseille, France
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Sun GZ, Wang HY, Ye N, Sun YX. Assessment of Novel Peguero-Lo Presti Electrocardiographic Left Ventricular Hypertrophy Criteria in a Large Asian Population: Newer May Not Be Better. Can J Cardiol 2018; 34:1153-1157. [PMID: 30170670 DOI: 10.1016/j.cjca.2018.05.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 04/29/2018] [Accepted: 05/11/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Recently, the novel Peguero-Lo Presti electrocardiographic criteria to diagnose left ventricular hypertrophy (LVH) were developed from Caucasian American population with a relatively high sensitivity. However, further validation on a large Asian population has never been conducted. Thus, this study was to test and validate the overall performance of this index in a general population from China. METHODS A total of 10,614 permanent residents ≥35 years of age were included in this study. All participants completed 12-lead electrocardiography and echocardiography at the same visit. A receiver-operating characteristic curve was used for comparing the performance of electrocardiographic indices in diagnosing echocardiographic LVH. RESULTS The Peguero-Lo Presti criteria had higher sensitivity but lower specificity than Cornell and Sokolow-Lyon voltage according to the recommended criteria. The area under the curve of this novel Peguero-Lo Presti voltage was lower than that of Cornell for predicting LVH defined by both left ventricular mass/body surface area (0.665 vs 0.699 in males; 0.689 vs 0.721 in females) and left ventricular mass/height2.7 (0.623 vs 0.681 in males; 0.642 vs 0.709 in females) (all Ps < 0.05). By changing cutoff values, Cornell voltage outperformed Peguero-Lo Presti whether to achieve a relatively high sensitivity or specificity. CONCLUSIONS The novel Peguero-Lo Presti voltage may not be a better screening tool for LVH in Asian population. In comparison with this new index, Cornell voltage could be a better screening test for LVH by changing its cutoff values to obtain maximum sensitivity.
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Affiliation(s)
- Guo-Zhe Sun
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Hao-Yu Wang
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ning Ye
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ying-Xian Sun
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China.
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Prevalence of early repolarization pattern and its association with sudden cardiac death and arrhythmia over one-year follow-up in an Egyptian cohort. Egypt Heart J 2018; 70:315-321. [PMID: 30591749 PMCID: PMC6303277 DOI: 10.1016/j.ehj.2018.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/04/2018] [Indexed: 12/12/2022] Open
Abstract
Background and objectives Early repolarization pattern (ERP) is not uncommon electrocardiography (ECG) finding and could be associated with arrhythmia and sudden cardiac death (SCD). We aimed to prospectively determine the prevalence of ERP and its association with arrhythmia and SCD during one-year follow-up in an outpatient Egyptian cohort. Methods Clinical assessment and ECG were performed to 1850 consecutive individuals presented at the outpatient clinic of Suez Canal University Hospital (SCUH). Then, the ERP group and 100 age and gender-matched ERP −ve controls had undergone echocardiography, 24-h Holter ECG and exercise stress ECG. Results ERP was found in 124 individuals (6.7%); we excluded 24 patients with structural heart disease. ERP group (No. = 100) were relatively young (80% <50 years-old) and showed male preponderance (60%). ERP frequencies were: inferolateral (50%), antero-lateral (38%), inferior (10%), and global (2%). ERP subjects were leaner than controls (BMI was 25.3 vs. 30 kg/m2, P value < 0.001) and achieved more metabolic equivalents (METS) on stress ECG (10.7 vs. 8.5 METS, P value < 0.01). Only 4% in the ERP group had horizontal/descending ST slope, while 8% had ST elevation ≥ 2 ms. No arrhythmia or SCD were reported during 1-year follow-up in both groups. Regression analysis showed that male gender, Sokolow-Lyon criteria and short QTc were significant independent predictors of ERP, P value < 0.05. Conclusions In outpatient-based Egyptian cohort, the prevalence of ERP was 6.7%, mostly the inferolateral pattern. Our ERP subjects had low-risk clinical and ECG criteria for malignant ERP. Further epidemiological studies are needed to explore the natural history of ERP.
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