An Epidemiologic Study of First Degree Atrioventricular Block in Tecumseh, Michigan

Perlman, Lawrence V.; Ostrander, Leon D.; Keller, Jacob B.; Chiang, Benjamin N.

doi:10.1378/chest.59.1.40

Cited by 33 publications

(32 citation statements)

References 16 publications

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“…Our present definition of a prolonged PR is in accordance with the definition given by the World Health Organization ( Rose and Blackburn, 1968) and by most authors and textbooks (e.g., Friedberg, 1967;Goldman, 1979;Haft, 1977;Perlman et al, 1971).…”

Section: Methodsmentioning

confidence: 55%

Natural course of a prolonged pr interval and the relation between pr and incidence of coronary heart disease. A 7‐year follow‐up study of 1832 apparently healthy men aged 40–59 years

Erikssen

Otterstad

1984

Clinical Cardiology

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Summary: During a baseline cardiovascular survey PR was measured in a strictly standardized way in 1832 men aged 40-59 years, free from coronary heart disease (CHD). Of 1758 men still alive, 1585 underwent an identical follow-up study 7 years later. A total of 1570 were in sinus rhythm. The following findings were made: (1) Baseline and follow-up prevalence of a prolonged PR ( 2 0 . 2 2 s) was identical (5.3 vs. 5.4%). (2) Only 60% of restudied men with a prolonged PR also had prolonged PR at follow-up. (3) Only 1 of 98 with a prolonged baseline PR had a more advanced AV block at follow-up, whereas an additional 4 had conditions which might influence the AV node (1 Bechterew's disease and 3 mild aortic valve stenosis). (4) The incidence of all CHD events found during the follow-up study (CHD deaths, myocardial infarction, angina pectons, and pathologic exercise ECGs) was moderately but significantly lower in men with a prolonged PR than among men with a PR 1 0 . 2 1 s. Thus a prolonged PR is rarely an indicator of impending, more severe conduction disturbances; it is mostly a benign, functional find- ing in middle-aged men free from overt heart disease and is not positively associated with CHD. Rather PR may be moderately and inversely associated with latent CHD.

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Section: Methodsmentioning

confidence: 55%

Natural course of a prolonged pr interval and the relation between pr and incidence of coronary heart disease. A 7‐year follow‐up study of 1832 apparently healthy men aged 40–59 years

Erikssen

Otterstad

1984

Clinical Cardiology

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“…The first, conducted in the 1960s in Tecumseh, Michigan, involving 4678 participants, showed no excess incidence of cardiovascular disease or mortality among persons with PR interval ≥220 ms during the 4-year observation period, although PR interval correlated with cardiac abnormalities especially in persons past 60 years of age. 7 However, the results of these previous studies have recently been challenged by an investigation of 7575 individuals from the Framingham Heart Study. 9 In this population-based sample, PR interval .200 ms predicted all-cause mortality, with unadjusted HR of 2.7 and multivariable-adjusted HR of 1.4, during the follow-up of 20 years, and was significantly associated with pacemaker implantation and incidence of AF.…”

Section: Discussionmentioning

confidence: 99%

“…This is in accordance with previous studies, some of which have demonstrated that the persistence of the first-degree AV block has been ,50% at least in some age groups. 5,7 This could be at least partly due to decreased vagal tone associated with ageing. Besides, PR interval shows a significant circadian variation, 35 which depends on the prevailing autonomic tone affecting AV conduction.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of prolonged PR interval in the general population

Aro

Anttonen

Kerola

et al. 2013

European Heart Journal

120

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AimsProlonged PR interval, or first degree AV block, has been traditionally regarded as a benign electrocardiographic finding in healthy individuals, until recent studies have suggested that it may be associated with increased mortality and morbidity. The aim of this study was to further elucidate clinical and prognostic importance of prolonged PR interval in a large middleaged population with a long follow-up. Methods and resultsWe evaluated 12-lead electrocardiograms of 10 785 individuals aged 30 -59 years (mean age 44 years, 52% males) recorded between 1966 and 1972, and followed the subjects for 30 + 11 years. Prolonged PR interval was defined as PR .200 ms, with further analysis performed using PR ≥220 ms. Main endpoints were all-cause mortality, cardiovascular mortality, and sudden cardiac death, and other endpoints included hospitalizations due to cardiovascular causes. During the baseline examination, prolonged PR interval .200 ms was present in 2.1% of the subjects, but PR interval normalized to ≤200 ms in 30% of these individuals during the follow-up. No increase in mortality or in hospitalizations due to coronary artery disease, heart failure, atrial fibrillation, or stroke was associated with prolonged PR interval (P ¼ non-significant for all endpoints). These results were not changed after multivariate adjustment or in several subanalyses. ConclusionIn the middle-aged general population, prolonged PR interval normalizes in a substantial proportion of subjects during the time course, and it is not associated with an increased risk of all-cause or cardiovascular mortality.--

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“…Arvo Obesity:-In our study, we found 29% cases to be obese and the association of obesity with the conduction abnormality was found to be significant (p=0.001). Lone NA 15 reported obesity in 47% of cases, Najar MS 16 in 34% and Perlman et al 6 reported obesity in 26% cases. In contrast, Ostrander et al 18 reported obesity in only 6% cases.…”

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confidence: 95%

“…3,6,7,8 All the patients were screened for cardiovascular risk factors as per defined criteria: 1. Hypertension: was considered to be present if the patient was taking anti-hypertensive medication at the time of presentation or If blood pressure recorded was equal to or greater than 140 mm Hg systolic and, equal to or greater than 90 mm Hg Diastolic , at least on two separate occasions.…”

mentioning

confidence: 99%

Cardiac Conduction Defects and Cardiovascular Risk Factors -a Hospital Based Study.

Ashraf¹,

Mir²,

Yousuf³

et al. 2017

IJAR

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Background:The interest in cardiac conduction system has focused primarily on its role as a predictor of mortality and coexistent cardiovascular diseases particularly hospitalised patients. Objectives: The study was undertaken to study the association of cardiac conduction defects with underlying cardiovascular diseases and various risk factors. Methodology: The study was conducted from 1st March 2012 to 31st august 2013 and included cases >20yrs of age presenting to OPD or admitted in SMHS hospital and showing some form of cardiac conduction defect on a standard 12 lead ECG. A total of 1710 cases were studied. A thorough medical history and meticulous physical examination was done and relevant investigations ordered to find out the presence of underlying cardiovascular diseases and risk factors Results: Of the 1710 cases, 990(57.9%) were males and 720(42.1%) were females. Most of cases were seen in the age group of 70-79yrs (25.7%). Risk factors including Hypertension was found in 1095(64%) cases, Coronary Artery Disease(CAD) in 445(26%), dyslipidemia in 429(25%), diabetes in 410(23.9%) and gout in 51(2.9%) cases. 1270(74%) cases were smokers, 632(36.9%) were having sedentary life style and 496(29%) cases were obese/overweight. Conclusion: Hypertension, smoking, CAD, obesity and sedentary life style are the major risk factors.

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An Epidemiologic Study of First Degree Atrioventricular Block in Tecumseh, Michigan

Cited by 33 publications

References 16 publications

Natural course of a prolonged pr interval and the relation between pr and incidence of coronary heart disease. A 7‐year follow‐up study of 1832 apparently healthy men aged 40–59 years

Natural course of a prolonged pr interval and the relation between pr and incidence of coronary heart disease. A 7‐year follow‐up study of 1832 apparently healthy men aged 40–59 years

Prognostic significance of prolonged PR interval in the general population

Cardiac Conduction Defects and Cardiovascular Risk Factors -a Hospital Based Study.

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