P-wave signal-averaged electrocardiography: Reference values, clinical correlates, and heritability in the Framingham Heart Study
Year: 2021
Type: article
Study design: Observational Study
Abstract: BACKGROUND: P-wave signal-averaged electrocardiography (P-SAECG) quantifies atrial electrical activity. P-SAECG measures and their clinical correlates and heritability have had limited characterization in community-based cohorts. OBJECTIVE: The purpose of this study was to (1) establish reference values; (2) identify clinical risk factors associated with P-SAECG; and (3) estimate genetic heritability for P-SAECG traits. METHODS: We performed P-SAECG in 2 generations of Framingham Heart Study participants. We performed backward elimination regression models to assess associations of clinical factors with each SAECG trait (P-wave [PW] duration, root mean square voltage in terminal 40 ms [RMS40], terminal 30 ms RMS30, terminal 20 ms RMS20, RMS PW, and PW integral). We estimated the adjusted genetic heritability of P-SAECG measures using the Sequential Oligogenic Linkage Analysis Routines (SOLAR) program. RESULTS: We included 4307 participants (age 55 ± 14 years; 56% female). The reference values were derived from 1752 participants without cardiovascular risk factors. Median (2.5th percentile; 97.5th percentile) total PW duration was 118 ms (93; 146) in women and 128 ms (104; 158) in men in the reference sample, and 121 ms (94; 151) in women and 129 ms (103; 159) in the entire study cohort (broad sample). In the broad sample, after adjusting for age and sex, total PW duration was positively associated with height, weight, prevalent heart failure, history of atrial fibrillation (AF), and atrioventricular node blockers, and negatively associated with smoking, waist circumference, heart rate, and diabetes. The estimated heritability of P-SAECG traits was moderate, ranging from 11.9% for RMS30 to 24.9% for PW integral. CONCLUSION: P-SAECG traits are associated with multiple AF-related risk factors and are moderately heritable.
Source: Heart Rhythm
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,330
Funders: American Heart Association, Merck, American College of Cardiology Foundation, FP7 Coherent Development of Research Policies, European Commission, National Institutes of Health, Horizon 2020 Framework Programme, Horizon 2020, National Institute on Aging, National Heart, Lung, and Blood Institute, H2020 Marie Skłodowska-Curie Actions
Awards: FHS-NEXT - Framingham Novel EXam using Technology, DIGITAL, RISK-BASED SCREENING FOR ATRIAL FIBRILLATION IN THE EUROPEAN COMMUNITY, A Mobile Relational Agent to Enhance Atrial Fibrillation Self-care, G278200998, G3405256882, AFGen Consortium: Atrial Fibrillation Genomics to Functional Analyses, Clinical and genetic prediction of lifetime risk of atrial fibrillation and its complications, G4294289925, G4976486911, G5164707915, G5415130407, Mobile Health intervention for rural atrial fibrillation, The Framingham Heart Study, IDENTIFICATION OF COMMON GENETIC VARIANTS FOR ATRIAL FIBRILLATION AND PR INTERVAL, CAPSITE: Community Assessment of Pain and Sensitization in the Elderly, G958930701, American Heart Association Tobacco Center for Regulatory Science (A-TRAC) 2.0
OpenAlex ID: W3163046262