Microvasculature and incident atrioventricular conduction abnormalities in the Multi-Ethnic Study of Atherosclerosis (MESA)

Billy G. Chacko, Matthew S. Edwards, A. Richey Sharrett, Waqas T. Qureshi, Barbara E K Klein, Ronald Klein, David M. Herrington, Elsayed Z. Soliman

Research output: Contribution to journalArticle

Abstract

Abnormalities of the microvasculature are linked to major cardiac events, but their role in the development of atrioventricular conduction abnormalities (AVCA) is unknown. We examined the association between central retinal arteriolar equivalent (CRAE), a measure of the microvasculature, and incident AVCA. This analysis included 3975 participants free of AVCA at baseline from the Multi-Ethnic Study of Atherosclerosis (MESA). Incident AVCA was defined as a composite of new heart rate-adjusted PR interval 3/4 200 ms (first-degree AV block) and advanced block (second-degree or complete AV block) detected from the MESA exam 5 electrocardiogram (ECG). CRAE was measured from retinal photographs at exam 2. Both ECGs and retinal photographs were collected using standardized methods and read and graded at central core labs. Incident AVCA were present in 7.4% (n=290) of the participants, of which 94% were first-degree AV block. Incident AVCA were increasingly more common in participants with narrower CRAE (4.6% in Q4, 6.4% in Q3, 7.0% in Q2 and 10.8% in Q1, p-value for trend <0.0001). The socio-demographic and cardiovascular disease risk-adjusted odds of incident AVCA in the Q1 group (the group with the narrowest retinal arteriolar diameter) was nearly twice the odds in the Q4 group (OR: 1.68, 95% CI: 1.15-2.51). This association remained significant after adjustment for major ECG abnormalities and incident cardiovascular disease (Q1 vs Q4, OR: 1.65, 95% CI: 1.01-2.71). In conclusion, narrower retinal arteriolar caliber is associated with development of new AV conduction abnormalities.

Original languageEnglish (US)
Pages (from-to)417-423
Number of pages7
JournalVascular Medicine
Volume20
Issue number5
DOIs
StatePublished - Oct 1 2015

Fingerprint

Atrioventricular Block
Microvessels
Atherosclerosis
Electrocardiography
Cardiovascular Diseases
Heart Rate
Demography

Keywords

  • Arteriolar
  • cardiovascular disease
  • microcirculation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Chacko, B. G., Edwards, M. S., Sharrett, A. R., Qureshi, W. T., Klein, B. E. K., Klein, R., ... Soliman, E. Z. (2015). Microvasculature and incident atrioventricular conduction abnormalities in the Multi-Ethnic Study of Atherosclerosis (MESA). Vascular Medicine, 20(5), 417-423. https://doi.org/10.1177/1358863X15586475

Microvasculature and incident atrioventricular conduction abnormalities in the Multi-Ethnic Study of Atherosclerosis (MESA). / Chacko, Billy G.; Edwards, Matthew S.; Sharrett, A. Richey; Qureshi, Waqas T.; Klein, Barbara E K; Klein, Ronald; Herrington, David M.; Soliman, Elsayed Z.

In: Vascular Medicine, Vol. 20, No. 5, 01.10.2015, p. 417-423.

Research output: Contribution to journalArticle

Chacko, BG, Edwards, MS, Sharrett, AR, Qureshi, WT, Klein, BEK, Klein, R, Herrington, DM & Soliman, EZ 2015, 'Microvasculature and incident atrioventricular conduction abnormalities in the Multi-Ethnic Study of Atherosclerosis (MESA)', Vascular Medicine, vol. 20, no. 5, pp. 417-423. https://doi.org/10.1177/1358863X15586475
Chacko, Billy G. ; Edwards, Matthew S. ; Sharrett, A. Richey ; Qureshi, Waqas T. ; Klein, Barbara E K ; Klein, Ronald ; Herrington, David M. ; Soliman, Elsayed Z. / Microvasculature and incident atrioventricular conduction abnormalities in the Multi-Ethnic Study of Atherosclerosis (MESA). In: Vascular Medicine. 2015 ; Vol. 20, No. 5. pp. 417-423.
@article{4c205cb489dc4d5ab231737c7ba7ce19,
title = "Microvasculature and incident atrioventricular conduction abnormalities in the Multi-Ethnic Study of Atherosclerosis (MESA)",
abstract = "Abnormalities of the microvasculature are linked to major cardiac events, but their role in the development of atrioventricular conduction abnormalities (AVCA) is unknown. We examined the association between central retinal arteriolar equivalent (CRAE), a measure of the microvasculature, and incident AVCA. This analysis included 3975 participants free of AVCA at baseline from the Multi-Ethnic Study of Atherosclerosis (MESA). Incident AVCA was defined as a composite of new heart rate-adjusted PR interval 3/4 200 ms (first-degree AV block) and advanced block (second-degree or complete AV block) detected from the MESA exam 5 electrocardiogram (ECG). CRAE was measured from retinal photographs at exam 2. Both ECGs and retinal photographs were collected using standardized methods and read and graded at central core labs. Incident AVCA were present in 7.4{\%} (n=290) of the participants, of which 94{\%} were first-degree AV block. Incident AVCA were increasingly more common in participants with narrower CRAE (4.6{\%} in Q4, 6.4{\%} in Q3, 7.0{\%} in Q2 and 10.8{\%} in Q1, p-value for trend <0.0001). The socio-demographic and cardiovascular disease risk-adjusted odds of incident AVCA in the Q1 group (the group with the narrowest retinal arteriolar diameter) was nearly twice the odds in the Q4 group (OR: 1.68, 95{\%} CI: 1.15-2.51). This association remained significant after adjustment for major ECG abnormalities and incident cardiovascular disease (Q1 vs Q4, OR: 1.65, 95{\%} CI: 1.01-2.71). In conclusion, narrower retinal arteriolar caliber is associated with development of new AV conduction abnormalities.",
keywords = "Arteriolar, cardiovascular disease, microcirculation",
author = "Chacko, {Billy G.} and Edwards, {Matthew S.} and Sharrett, {A. Richey} and Qureshi, {Waqas T.} and Klein, {Barbara E K} and Ronald Klein and Herrington, {David M.} and Soliman, {Elsayed Z.}",
year = "2015",
month = "10",
day = "1",
doi = "10.1177/1358863X15586475",
language = "English (US)",
volume = "20",
pages = "417--423",
journal = "Vascular Medicine",
issn = "1358-863X",
publisher = "SAGE Publications Ltd",
number = "5",

}

TY - JOUR

T1 - Microvasculature and incident atrioventricular conduction abnormalities in the Multi-Ethnic Study of Atherosclerosis (MESA)

AU - Chacko, Billy G.

AU - Edwards, Matthew S.

AU - Sharrett, A. Richey

AU - Qureshi, Waqas T.

AU - Klein, Barbara E K

AU - Klein, Ronald

AU - Herrington, David M.

AU - Soliman, Elsayed Z.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Abnormalities of the microvasculature are linked to major cardiac events, but their role in the development of atrioventricular conduction abnormalities (AVCA) is unknown. We examined the association between central retinal arteriolar equivalent (CRAE), a measure of the microvasculature, and incident AVCA. This analysis included 3975 participants free of AVCA at baseline from the Multi-Ethnic Study of Atherosclerosis (MESA). Incident AVCA was defined as a composite of new heart rate-adjusted PR interval 3/4 200 ms (first-degree AV block) and advanced block (second-degree or complete AV block) detected from the MESA exam 5 electrocardiogram (ECG). CRAE was measured from retinal photographs at exam 2. Both ECGs and retinal photographs were collected using standardized methods and read and graded at central core labs. Incident AVCA were present in 7.4% (n=290) of the participants, of which 94% were first-degree AV block. Incident AVCA were increasingly more common in participants with narrower CRAE (4.6% in Q4, 6.4% in Q3, 7.0% in Q2 and 10.8% in Q1, p-value for trend <0.0001). The socio-demographic and cardiovascular disease risk-adjusted odds of incident AVCA in the Q1 group (the group with the narrowest retinal arteriolar diameter) was nearly twice the odds in the Q4 group (OR: 1.68, 95% CI: 1.15-2.51). This association remained significant after adjustment for major ECG abnormalities and incident cardiovascular disease (Q1 vs Q4, OR: 1.65, 95% CI: 1.01-2.71). In conclusion, narrower retinal arteriolar caliber is associated with development of new AV conduction abnormalities.

AB - Abnormalities of the microvasculature are linked to major cardiac events, but their role in the development of atrioventricular conduction abnormalities (AVCA) is unknown. We examined the association between central retinal arteriolar equivalent (CRAE), a measure of the microvasculature, and incident AVCA. This analysis included 3975 participants free of AVCA at baseline from the Multi-Ethnic Study of Atherosclerosis (MESA). Incident AVCA was defined as a composite of new heart rate-adjusted PR interval 3/4 200 ms (first-degree AV block) and advanced block (second-degree or complete AV block) detected from the MESA exam 5 electrocardiogram (ECG). CRAE was measured from retinal photographs at exam 2. Both ECGs and retinal photographs were collected using standardized methods and read and graded at central core labs. Incident AVCA were present in 7.4% (n=290) of the participants, of which 94% were first-degree AV block. Incident AVCA were increasingly more common in participants with narrower CRAE (4.6% in Q4, 6.4% in Q3, 7.0% in Q2 and 10.8% in Q1, p-value for trend <0.0001). The socio-demographic and cardiovascular disease risk-adjusted odds of incident AVCA in the Q1 group (the group with the narrowest retinal arteriolar diameter) was nearly twice the odds in the Q4 group (OR: 1.68, 95% CI: 1.15-2.51). This association remained significant after adjustment for major ECG abnormalities and incident cardiovascular disease (Q1 vs Q4, OR: 1.65, 95% CI: 1.01-2.71). In conclusion, narrower retinal arteriolar caliber is associated with development of new AV conduction abnormalities.

KW - Arteriolar

KW - cardiovascular disease

KW - microcirculation

UR - http://www.scopus.com/inward/record.url?scp=84943165207&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84943165207&partnerID=8YFLogxK

U2 - 10.1177/1358863X15586475

DO - 10.1177/1358863X15586475

M3 - Article

VL - 20

SP - 417

EP - 423

JO - Vascular Medicine

JF - Vascular Medicine

SN - 1358-863X

IS - 5

ER -