Arterial stiffness and atrial fibrillation: shared mechanisms, clinical implications and therapeutic options

Vio, Riccardo; Giordani, Andrea Silvio; Stefil, Maria; Madine, Jillian; Fairbairn, Timothy; Themistoclakis, Sakis; Salvi, Paolo; Caforio, Alida Linda Patrizia; Shantsila, Alena; Shantsila, Eduard; Akhtar, Riaz; Field, Mark; Lip, Gregory Y.H.; Proietti, Riccardo

doi:10.1097/hjh.0000000000003223

Cited by 3 publications

(4 citation statements)

References 92 publications

(110 reference statements)

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“…However, the results might also be due to the relatively insufficient power in the BMI < 24 group, with a relatively low incidence of AF in comparison (0.23% vs. 0.51%). The risk of AF was increased significantly in both the borderline AS group and the elevated AS group in the non-hypertensive population, as demonstrated in prior studies 26,30 . There was a linear relationship and consistency between ePWV and baPWV; notably, ePWV is significantly higher in non-hypertensive subjects than in the general population, also serving as a risk factor for AF 30 .…”

Section: Discussionsupporting

confidence: 74%

“…Several methods exist for analyzing the structure and function of large arteries 24,25 , including echo-tracking systems, central pulse pressure analysis, and magnetic resonance that quantifies aortic distension and compliance 26 . However, the PWV measurement is currently considered the optimal measurement of AS because of its accuracy, simplicity, reproducibility.…”

Section: Discussionmentioning

confidence: 99%

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Association between brachial-ankle pulse wave velocity and the risk of new-onset atrial fibrillation: A report from Kailuan prospective cohort study

Song,

Zhang

et al. 2024

npj Cardiovasc Health

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One marker of arterial stiffness (AS) is the brachial-ankle pulse wave velocity (baPWV). We aim to investigate the predictive value of baPWV with regard to new-onset atrial fibrillation (AF). All participants without AF from 2010 to 2020 in the Kailuan cohort were included. The primary endpoint was new-onset AF. Participants were categorized into three study groups based on baPWV, with a normal baPWV group as a reference. The predictive value of baPWV was analyzed as a continuous variable. Multivariable Cox proportional hazard regression models were used to investigate the association. A total of 49,872 subjects (mean age: 47.57 years old, 74.2% male) were included with a mean follow-up of 6.17 (3.95–8.46) years. The risk of AF increased as the baseline baPWV increased, whereby the adjusted hazard ratio (aHR) of the borderline AS group and the elevated AS group were 1.82 (95% confidence interval [CI]: 1.18–2.80) and 2.08 (95% CI: 1.31–3.30), respectively. When considered as a continuous variable, each 361 cm/s increase in baseline baPWV, increased the risk of AF by 21.7% (aHR: 1.22; 95% CI: 1.08–1.37). In the subgroup analysis of non-hypertensive patients, the risks of AF were significantly higher in the borderline AS group (aHR: 3.16, 95% CI: 1.74–5.74) and elevated AS group (aHR: 2.26, 95% CI: 1.02–5.05). For patients with elevated BMI, the risk of AF in the elevated AS group was significantly higher (aHR: 1.69, 95% CI: 1.00–2.83). Baseline baPWV was associated with new-onset AF after adjustments. (Trial registration site and registration number are, respectively, http://www.chictr.org.cn/index.aspx and ChiCTR-TNRC-11001489).

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Association between brachial-ankle pulse wave velocity and the risk of new-onset atrial fibrillation: A report from Kailuan prospective cohort study

Song,

Zhang

et al. 2024

npj Cardiovasc Health

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“…Likewise, in a cohort of 1156 individuals, AoStiff had a negative impact on LA function, independently of LV volume and function, as well as brain natriuretic peptide (BNP) levels [ 44 ]. Finally, a recent study reported that in patients with increased AoStiff, there is high risk for incident AF, and the subset of AF patients with increased AoStiff seems to be more symptomatic, while rhythm control strategies are less effective [ 45 ]. Thus, the combined influence of AoStiff and hypertension on atrial myocardial structure and electrical activity promotes AF development.…”

Section: Cardiovascular Disordersmentioning

confidence: 99%

Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly

Triposkiadis

Xanthopoulos

Λαμπρόπουλος

et al. 2023

JCM

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Multimorbidity, the coexistence of multiple health conditions in an individual, has emerged as one of the greatest challenges facing health services, and this crisis is partly driven by the aging population. Aging is associated with increased aortic stiffness (AoStiff), which in turn is linked with several morbidities frequently affecting and having disastrous consequences for the elderly. These include hypertension, ischemic heart disease, heart failure, atrial fibrillation, chronic kidney disease, anemia, ischemic stroke, and dementia. Two or more of these disorders (multimorbidity) often coexist in the same elderly patient and the specific multimorbidity pattern depends on several factors including sex, ethnicity, common morbidity routes, morbidity interactions, and genomics. Regular exercise, salt restriction, statins in patients at high atherosclerotic risk, and stringent blood pressure control are interventions that delay progression of AoStiff and most likely decrease multimorbidity in the elderly.

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“…Atrial fibrillation is one of the most prevalent arrhythmias in the general population, and its incidence dramatically increases with aging [ 76 ]. Several studies reported that elevated arterial stiffness increases the risk of atrial fibrillation [ 77 ]. Although the exact pathophysiology is still not known, a central role of pulse pressure has been hypothesized.…”

Section: Increased Arterial Stiffness and Clinical Outcomementioning

confidence: 99%

Aging of the Arterial System

Castelli

Gidaro

Casu

et al. 2023

IJMS

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Aging of the vascular system is associated with deep changes of the structural proprieties of the arterial wall. Arterial hypertension, diabetes mellitus, and chronic kidney disease are the major determinants for the loss of elasticity and reduced compliance of vascular wall. Arterial stiffness is a key parameter for assessing the elasticity of the arterial wall and can be easily evaluated with non-invasive methods, such as pulse wave velocity. Early assessment of vessel stiffness is critical because its alteration can precede clinical manifestation of cardiovascular disease. Although there is no specific pharmacological target for arterial stiffness, the treatment of its risk factors helps to improve the elasticity of the arterial wall.

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Arterial stiffness and atrial fibrillation: shared mechanisms, clinical implications and therapeutic options

Cited by 3 publications

References 92 publications

Association between brachial-ankle pulse wave velocity and the risk of new-onset atrial fibrillation: A report from Kailuan prospective cohort study

Association between brachial-ankle pulse wave velocity and the risk of new-onset atrial fibrillation: A report from Kailuan prospective cohort study

Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly

Aging of the Arterial System

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