Electrocardiographic left atrial abnormality and silent vascular brain injury: The Northern Manhattan Study

Madeleine D. Hunter, Yeseon Park Moon, Charles DeCarli, Jose Gutierrez, Clinton B Wright, Marco R.Di Tullio, Ralph L Sacco, Hooman Kamel, Mitchell S.V. Elkind

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

We hypothesized that P wave terminal Force in the V1 lead (PTFV1) would be associated with leukoaraiosis and subclinical infarcts, especially cortical infarcts, in a population-based, multi-ethnic cohort. Methods PTFV1 was collected manually from baseline electrocardiograms of clinically stroke-free Northern Manhattan Study participants. Investigators read brain MRIs for superficial infarcts, deep infarcts, and white matter hyperintensity volume (WMHV). WMHV was adjusted for head size and log transformed, achieving a normal distribution. Logistic regression models investigated the association of PTFV1 with cortical and with all subclinical infarcts. Linear regression models examined logWMHV. Models were adjusted for demographics and risk factors. Results Among 1174 participants with PTFV1 measurements, the mean age at MRI was 70±9 years. Participants were 14.4% white, 17.6% black, and 65.8% Hispanic. Mean PTFV1 was 3587.35±2315.62 ìV-ms. Of the 170 subclinical infarcts, 40 were cortical. PTFV1 ≥5000 μV-ms was associated with WMHV in a fully adjusted model (mean difference in logWMHV 0.15, 95% confidence interval 0.01±0.28). PTFV1 exhibited a trend toward an association with cortical infarcts (unadjusted OR per SD change logPTFV1 1.30, 95% CI 0.94±1.81), but not with all subclinical infarcts. Conclusion Electrocardiographic evidence of left atrial abnormality was associated with leukoaraiosis.

Original languageEnglish (US)
Article numbere0203774
JournalPLoS One
Volume13
Issue number10
DOIs
StatePublished - Oct 1 2018

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Cerebrovascular Trauma
infarction
blood vessels
Brain
brain
Leukoaraiosis
Magnetic resonance imaging
Linear Models
Logistic Models
Normal Distribution
Normal distribution
Lead
Electrocardiography
electrocardiography
Hispanic Americans
Linear regression
Logistics
stroke
confidence interval
Stroke

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Hunter, M. D., Moon, Y. P., DeCarli, C., Gutierrez, J., Wright, C. B., Tullio, M. R. D., ... Elkind, M. S. V. (2018). Electrocardiographic left atrial abnormality and silent vascular brain injury: The Northern Manhattan Study. PLoS One, 13(10), [e0203774]. https://doi.org/10.1371/journal.pone.0203774

Electrocardiographic left atrial abnormality and silent vascular brain injury : The Northern Manhattan Study. / Hunter, Madeleine D.; Moon, Yeseon Park; DeCarli, Charles; Gutierrez, Jose; Wright, Clinton B; Tullio, Marco R.Di; Sacco, Ralph L; Kamel, Hooman; Elkind, Mitchell S.V.

In: PLoS One, Vol. 13, No. 10, e0203774, 01.10.2018.

Research output: Contribution to journalArticle

Hunter, MD, Moon, YP, DeCarli, C, Gutierrez, J, Wright, CB, Tullio, MRD, Sacco, RL, Kamel, H & Elkind, MSV 2018, 'Electrocardiographic left atrial abnormality and silent vascular brain injury: The Northern Manhattan Study', PLoS One, vol. 13, no. 10, e0203774. https://doi.org/10.1371/journal.pone.0203774
Hunter MD, Moon YP, DeCarli C, Gutierrez J, Wright CB, Tullio MRD et al. Electrocardiographic left atrial abnormality and silent vascular brain injury: The Northern Manhattan Study. PLoS One. 2018 Oct 1;13(10). e0203774. https://doi.org/10.1371/journal.pone.0203774
Hunter, Madeleine D. ; Moon, Yeseon Park ; DeCarli, Charles ; Gutierrez, Jose ; Wright, Clinton B ; Tullio, Marco R.Di ; Sacco, Ralph L ; Kamel, Hooman ; Elkind, Mitchell S.V. / Electrocardiographic left atrial abnormality and silent vascular brain injury : The Northern Manhattan Study. In: PLoS One. 2018 ; Vol. 13, No. 10.
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abstract = "We hypothesized that P wave terminal Force in the V1 lead (PTFV1) would be associated with leukoaraiosis and subclinical infarcts, especially cortical infarcts, in a population-based, multi-ethnic cohort. Methods PTFV1 was collected manually from baseline electrocardiograms of clinically stroke-free Northern Manhattan Study participants. Investigators read brain MRIs for superficial infarcts, deep infarcts, and white matter hyperintensity volume (WMHV). WMHV was adjusted for head size and log transformed, achieving a normal distribution. Logistic regression models investigated the association of PTFV1 with cortical and with all subclinical infarcts. Linear regression models examined logWMHV. Models were adjusted for demographics and risk factors. Results Among 1174 participants with PTFV1 measurements, the mean age at MRI was 70±9 years. Participants were 14.4{\%} white, 17.6{\%} black, and 65.8{\%} Hispanic. Mean PTFV1 was 3587.35±2315.62 {\`i}V-ms. Of the 170 subclinical infarcts, 40 were cortical. PTFV1 ≥5000 μV-ms was associated with WMHV in a fully adjusted model (mean difference in logWMHV 0.15, 95{\%} confidence interval 0.01±0.28). PTFV1 exhibited a trend toward an association with cortical infarcts (unadjusted OR per SD change logPTFV1 1.30, 95{\%} CI 0.94±1.81), but not with all subclinical infarcts. Conclusion Electrocardiographic evidence of left atrial abnormality was associated with leukoaraiosis.",
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