Brachial flow-mediated dilation and incident atrial fibrillation the multi-ethnic study of atherosclerosis

Wesley T. O'Neal, Jimmy T. Efird, Joseph Yeboah, Saman Nazarian, Alvaro Alonso, Susan R. Heckbert, Elsayed Z. Soliman

Research output: Contribution to journalArticle

Abstract

Objective-It is unknown whether endothelial dysfunction precedes atrial fibrillation (AF) development. The objective of this study was to examine the association of brachial flow-mediated dilation (FMD) with incident AF.

Approach and Results-A total of 2936 participants (mean age, 61±9.9 years; 50% women; 66% nonwhites) from the Multi-Ethnic Study of Atherosclerosis with available ultrasound brachial FMD measurements who were free of baseline AF were included in this analysis. Baseline (2000-2002) FMD was computed from the percentage difference (%FMD) in brachial artery diameter and maximum diameter during measured vasodilator response. AF was ascertained from hospitalization data including Medicare claims during a median follow-up of 8.5 years. Probability-weighted Cox proportional-hazards regression was used to compute hazard ratios and 95% confidence intervals for the association between FMD as a continuous variable (%FMD values per 1-SD increase) and incident AF. Incident AF was detected in 137 (4.7%) participants. Those with %FMD values below the sex-specific median value (median %FMD; men, 3.6%; women, 4.2%; incidence rate per 1000 person-years, 7.3; 95% confidence interval, 5.9-9.0) were more likely to develop AF than people whose %FMD values were above the median value (incidence rate per 1000 person-years, 4.5; 95% confidence interval, 3.4-5.8; log-rank P=0.0043). In a multivariable Cox regression analysis, each 1-SD increase in %FMD values (SD, 2.8%) was associated with less incident AF (hazard ratio, 0.84; 95% confidence interval, 0.70-0.99). These results were consistent across subgroups stratified by age, sex, and race/ethnicity.

Conclusions-Smaller brachial FMD values are associated with higher rates of AF, suggesting a role for endothelial dysfunction in AF pathogenesis.

Original languageEnglish (US)
Pages (from-to)2717-2720
Number of pages4
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume34
Issue number12
DOIs
StatePublished - Dec 11 2014

Fingerprint

Atrial Fibrillation
Dilatation
Atherosclerosis
Arm
Confidence Intervals
Brachial Artery
Incidence
Medicare
Vasodilator Agents
Hospitalization
Regression Analysis

Keywords

  • Atrial fibrillation
  • Endothelium
  • Epidemiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

O'Neal, W. T., Efird, J. T., Yeboah, J., Nazarian, S., Alonso, A., Heckbert, S. R., & Soliman, E. Z. (2014). Brachial flow-mediated dilation and incident atrial fibrillation the multi-ethnic study of atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology, 34(12), 2717-2720. https://doi.org/10.1161/ATVBAHA.114.304560

Brachial flow-mediated dilation and incident atrial fibrillation the multi-ethnic study of atherosclerosis. / O'Neal, Wesley T.; Efird, Jimmy T.; Yeboah, Joseph; Nazarian, Saman; Alonso, Alvaro; Heckbert, Susan R.; Soliman, Elsayed Z.

In: Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 34, No. 12, 11.12.2014, p. 2717-2720.

Research output: Contribution to journalArticle

O'Neal, Wesley T. ; Efird, Jimmy T. ; Yeboah, Joseph ; Nazarian, Saman ; Alonso, Alvaro ; Heckbert, Susan R. ; Soliman, Elsayed Z. / Brachial flow-mediated dilation and incident atrial fibrillation the multi-ethnic study of atherosclerosis. In: Arteriosclerosis, Thrombosis, and Vascular Biology. 2014 ; Vol. 34, No. 12. pp. 2717-2720.
@article{89ff878cd10845d797a6157e150c709a,
title = "Brachial flow-mediated dilation and incident atrial fibrillation the multi-ethnic study of atherosclerosis",
abstract = "Objective-It is unknown whether endothelial dysfunction precedes atrial fibrillation (AF) development. The objective of this study was to examine the association of brachial flow-mediated dilation (FMD) with incident AF.Approach and Results-A total of 2936 participants (mean age, 61±9.9 years; 50{\%} women; 66{\%} nonwhites) from the Multi-Ethnic Study of Atherosclerosis with available ultrasound brachial FMD measurements who were free of baseline AF were included in this analysis. Baseline (2000-2002) FMD was computed from the percentage difference ({\%}FMD) in brachial artery diameter and maximum diameter during measured vasodilator response. AF was ascertained from hospitalization data including Medicare claims during a median follow-up of 8.5 years. Probability-weighted Cox proportional-hazards regression was used to compute hazard ratios and 95{\%} confidence intervals for the association between FMD as a continuous variable ({\%}FMD values per 1-SD increase) and incident AF. Incident AF was detected in 137 (4.7{\%}) participants. Those with {\%}FMD values below the sex-specific median value (median {\%}FMD; men, 3.6{\%}; women, 4.2{\%}; incidence rate per 1000 person-years, 7.3; 95{\%} confidence interval, 5.9-9.0) were more likely to develop AF than people whose {\%}FMD values were above the median value (incidence rate per 1000 person-years, 4.5; 95{\%} confidence interval, 3.4-5.8; log-rank P=0.0043). In a multivariable Cox regression analysis, each 1-SD increase in {\%}FMD values (SD, 2.8{\%}) was associated with less incident AF (hazard ratio, 0.84; 95{\%} confidence interval, 0.70-0.99). These results were consistent across subgroups stratified by age, sex, and race/ethnicity.Conclusions-Smaller brachial FMD values are associated with higher rates of AF, suggesting a role for endothelial dysfunction in AF pathogenesis.",
keywords = "Atrial fibrillation, Endothelium, Epidemiology",
author = "O'Neal, {Wesley T.} and Efird, {Jimmy T.} and Joseph Yeboah and Saman Nazarian and Alvaro Alonso and Heckbert, {Susan R.} and Soliman, {Elsayed Z.}",
year = "2014",
month = "12",
day = "11",
doi = "10.1161/ATVBAHA.114.304560",
language = "English (US)",
volume = "34",
pages = "2717--2720",
journal = "Arteriosclerosis, Thrombosis, and Vascular Biology",
issn = "1079-5642",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Brachial flow-mediated dilation and incident atrial fibrillation the multi-ethnic study of atherosclerosis

AU - O'Neal, Wesley T.

AU - Efird, Jimmy T.

AU - Yeboah, Joseph

AU - Nazarian, Saman

AU - Alonso, Alvaro

AU - Heckbert, Susan R.

AU - Soliman, Elsayed Z.

PY - 2014/12/11

Y1 - 2014/12/11

N2 - Objective-It is unknown whether endothelial dysfunction precedes atrial fibrillation (AF) development. The objective of this study was to examine the association of brachial flow-mediated dilation (FMD) with incident AF.Approach and Results-A total of 2936 participants (mean age, 61±9.9 years; 50% women; 66% nonwhites) from the Multi-Ethnic Study of Atherosclerosis with available ultrasound brachial FMD measurements who were free of baseline AF were included in this analysis. Baseline (2000-2002) FMD was computed from the percentage difference (%FMD) in brachial artery diameter and maximum diameter during measured vasodilator response. AF was ascertained from hospitalization data including Medicare claims during a median follow-up of 8.5 years. Probability-weighted Cox proportional-hazards regression was used to compute hazard ratios and 95% confidence intervals for the association between FMD as a continuous variable (%FMD values per 1-SD increase) and incident AF. Incident AF was detected in 137 (4.7%) participants. Those with %FMD values below the sex-specific median value (median %FMD; men, 3.6%; women, 4.2%; incidence rate per 1000 person-years, 7.3; 95% confidence interval, 5.9-9.0) were more likely to develop AF than people whose %FMD values were above the median value (incidence rate per 1000 person-years, 4.5; 95% confidence interval, 3.4-5.8; log-rank P=0.0043). In a multivariable Cox regression analysis, each 1-SD increase in %FMD values (SD, 2.8%) was associated with less incident AF (hazard ratio, 0.84; 95% confidence interval, 0.70-0.99). These results were consistent across subgroups stratified by age, sex, and race/ethnicity.Conclusions-Smaller brachial FMD values are associated with higher rates of AF, suggesting a role for endothelial dysfunction in AF pathogenesis.

AB - Objective-It is unknown whether endothelial dysfunction precedes atrial fibrillation (AF) development. The objective of this study was to examine the association of brachial flow-mediated dilation (FMD) with incident AF.Approach and Results-A total of 2936 participants (mean age, 61±9.9 years; 50% women; 66% nonwhites) from the Multi-Ethnic Study of Atherosclerosis with available ultrasound brachial FMD measurements who were free of baseline AF were included in this analysis. Baseline (2000-2002) FMD was computed from the percentage difference (%FMD) in brachial artery diameter and maximum diameter during measured vasodilator response. AF was ascertained from hospitalization data including Medicare claims during a median follow-up of 8.5 years. Probability-weighted Cox proportional-hazards regression was used to compute hazard ratios and 95% confidence intervals for the association between FMD as a continuous variable (%FMD values per 1-SD increase) and incident AF. Incident AF was detected in 137 (4.7%) participants. Those with %FMD values below the sex-specific median value (median %FMD; men, 3.6%; women, 4.2%; incidence rate per 1000 person-years, 7.3; 95% confidence interval, 5.9-9.0) were more likely to develop AF than people whose %FMD values were above the median value (incidence rate per 1000 person-years, 4.5; 95% confidence interval, 3.4-5.8; log-rank P=0.0043). In a multivariable Cox regression analysis, each 1-SD increase in %FMD values (SD, 2.8%) was associated with less incident AF (hazard ratio, 0.84; 95% confidence interval, 0.70-0.99). These results were consistent across subgroups stratified by age, sex, and race/ethnicity.Conclusions-Smaller brachial FMD values are associated with higher rates of AF, suggesting a role for endothelial dysfunction in AF pathogenesis.

KW - Atrial fibrillation

KW - Endothelium

KW - Epidemiology

UR - http://www.scopus.com/inward/record.url?scp=84918790063&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84918790063&partnerID=8YFLogxK

U2 - 10.1161/ATVBAHA.114.304560

DO - 10.1161/ATVBAHA.114.304560

M3 - Article

C2 - 25341797

AN - SCOPUS:84918790063

VL - 34

SP - 2717

EP - 2720

JO - Arteriosclerosis, Thrombosis, and Vascular Biology

JF - Arteriosclerosis, Thrombosis, and Vascular Biology

SN - 1079-5642

IS - 12

ER -