Key result
Excessive supraventricular ectopic activity is linked to ~58% higher risk of white matter hyperintensity.
Why the study?
The association between increased supraventricular ectopic beats and subclinical cerebrovascular disease remains unclear, despite emerging views that ectopy marks atrial cardiomyopathy or atherosclerosis.
Is excessive supraventricular ectopic activity associated with a higher burden of subclinical cerebrovascular disease in middle-aged to older men without stroke or atrial fibrillation?
Cross-Sectional (n=462)
Is excessive supraventricular ectopic activity associated with a higher burden of subclinical cerebrovascular disease in middle-aged to older men without stroke or atrial fibrillation?
Excessive supraventricular ectopic activity is independently associated with higher burdens of white matter hyperintensity and intracranial atherosclerotic stenosis, suggesting its potential utility in risk-stratifying individuals for subclinical cerebrovascular disease.
Answers are grounded in this paper and cite their sources.
ESVEA may support risk stratification for subclinical cerebrovascular disease; leaves open causal links and clinical utility pending longitudinal data.
Background and purposeThe association between an increased supraventricular ectopic beat (SVEB) and subclinical cerebrovascular disease remains unclear. Given the emerging concept that an increased SVEB is a marker of atrial cardiomyopathy or atherosclerosis burden, we sought to determine whether excessive supraventricular ectopic activity (ESVEA) is associated with a higher burden of subclinical cerebrovascular disease in the middle‐aged to older cohort with neither apparent stroke nor atrial fibrillation.MethodsWe conducted a cross‐sectional population‐based study of 462 men (mean age, 68.1 years) who underwent 24‐h Holter electrocardiography and brain magnetic resonance imaging. ESVEA was defined as the presence of >10 SVEBs/h. Subclinical cerebrovascular diseases were defined as silent brain infarct (SBI), white matter hyperintensity (WMH) and intracranial atherosclerotic stenosis (ICAS). The association of ESVEA with the presence of subclinical cerebrovascular diseases was adjusted for potential confounding covariates.ResultsA total of 88 (19.0%) participants had ESVEA and 81 (17.5%), 91 (19.7%) and 109 (23.6%) had SBI, WMH and ICAS, respectively. In multivariable‐adjusted Poisson regression with robust error variance, ESVEA was associated with the presence of WMH (relative risk, 1.58; 95% confidence interval, 1.06–2.36) and ICAS (relative risk, 1.49; 95% confidence interval, 1.02–2.18), but not with that of SBI (relative risk, 1.32; 95% confidence interval, 0.86–2.01). These associations were consistent when the graded distributions of subclinical cerebrovascular diseases were applied as outcomes in ordinal logistic regression.ConclusionsThe ESVEA was independently associated with higher burdens of WMH and ICAS. This suggests that increased SVEBs might improve risk stratification of individuals at high risk of subclinical cerebrovascular disease and consequently apparent ischaemic stroke.
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Hisamatsu et al. (2019) conducted a cross-sectional in Subclinical cerebrovascular disease (n=462). Excessive supraventricular ectopic activity (ESVEA) vs. Without excessive supraventricular ectopic activity was evaluated on Presence of white matter hyperintensity (WMH) (RR 1.58, 95% CI 1.06-2.36). Excessive supraventricular ectopic activity was associated with the presence of white matter hyperintensity (RR 1.58; 95% CI 1.06-2.36) and intracranial atherosclerotic stenosis.
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