Relations of arterial stiffness and brachial flow-mediated dilation with new-onset atrial fibrillation

Amir Y. Shaikh, Na Wang, Xiaoyan Yin, Martin G. Larson, Ramachandran S. Vasan, Naomi M. Hamburg, Jared W. Magnani, Patrick T. Ellinor, Steven A. Lubitz, Gary F. Mitchell, Emelia J. Benjamin, David D. McManus

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

The relations of measures of arterial stiffness, pulsatile hemodynamic load, and endothelial dysfunction to atrial fibrillation (AF) remain poorly understood. To better understand the pathophysiology of AF, we examined associations between noninvasive measures of vascular function and new-onset AF. The study sample included participants aged ≥45 years from the Framingham Heart Study offspring and third-generation cohorts. Using Cox proportional hazards regression models, we examined relations between incident AF and tonometry measures of arterial stiffness (carotid-femoral pulse wave velocity), wave reflection (augmentation index), pressure pulsatility (central pulse pressure), endothelial function (flow-mediated dilation), resting brachial arterial diameter, and hyperemic flow. AF developed in 407/5797 participants in the tonometry sample and 270/3921 participants in the endothelial function sample during follow-up (median 7.1 years, maximum 10 years). Higher augmentation index (hazard ratio, 1.16; 95% confidence interval, 1.02-1.32; P=0.02), baseline brachial artery diameter (hazard ratio, 1.20; 95% confidence interval, 1.01-1.43; P=0.04), and lower flow-mediated dilation (hazard ratio, 0.79; 95% confidence interval, 0.63-0.99; P=0.04) were associated with increased risk of incident AF. Central pulse pressure, when adjusted for age, sex, and hypertension (hazard ratio, 1.14; 95% confidence interval, 1.02-1.28; P=0.02) was associated with incident AF. Higher pulsatile load assessed by central pulse pressure and greater apparent wave reflection measured by augmentation index were associated with increased risk of incident AF. Vascular endothelial dysfunction may precede development of AF. These measures may be additional risk factors or markers of subclinical cardiovascular disease associated with increased risk of incident AF.

Original languageEnglish (US)
Pages (from-to)590-596
Number of pages7
JournalHypertension
Volume68
Issue number3
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Keywords

  • arrhythmia
  • augmentation index
  • flow-mediated dilation
  • pulse wave velocity
  • tonometry

ASJC Scopus subject areas

  • Internal Medicine

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