Electrocardiographic Left Atrial Abnormality and B-Type Natriuretic Peptide in a General Japanese Population: NIPPON DATA2010

Abstract

Aims: P-wave terminal force in lead V1 (PTFV1) is an electrocardiogram marker of increased left atrial pressure and may be a noninvasive and early detectable marker for future cardiovascular events in the general population compared to serum B-type natriuretic peptide (BNP) concentration. The clinical significance of PTFV1 in the contemporary general population is an area of unmet need. We aimed to demonstrate the correlation between PTFV1 and BNP concentrations in a contemporary representative Japanese population.Methods: Among 2,898 adult men and women from 300 randomly selected districts throughout Japan (NIP-PON DATA2010), we analyzed 2,556 participants without cardiovascular disease (stroke, myocardial infarction, and atrial fibrillation). Elevated BNP was defined as a value of ≥ 20 pg/mL based on the definition from the Japanese Circulation Society guidelines. Results:In total, 125 (4.9%) participants had PTFV1. Participants with PTFV1 were older with a higher prevalence of hypertension, major electrocardiographic findings, and elevated BNP concentrations (13.5 [6.9, 22.8] versus 7.8 [4.4, 14.5] pg/mL; P 0.001). After adjustment for confounders, PTFV1 was correlated with elevated BNP (odds ratio, 1.66; 95% confidence interval, 1.05-2.62; P 0.030). This correlation was consistent among various subgroups and was particularly evident in those aged 65 years or those without a history of hypertension. Conclusions:In the contemporary general population cohort, PTFV1 was independently related to high BNP concentration. PTFV1 may be an alternative marker to BNP in identifying individuals at a higher risk of future cardiovascular events in the East Asian population. cause of death worldwide in both men and women 1) . There is considerable evidence that the onset of CVD may be delayed or prevented through interventions

P‐wave parameters and their association with thrombi and spontaneous echo contrast in the left atrial appendage

“…In a representative Finnish population sample the prevalences of abnormal PTFV1, partial, and advanced IAB were 4.9%, 11.8%, and 1.9% 32 . A Japanese study also demonstrated a prevalence for PTFV1 of 4.9% 33 . In another Finnish cohort, incidence rates for prolonged P‐wave duration, abnormal PTFV1, left P‐wave axis deviation, and right P‐wave axis deviation were found to be 16.0%, 7.4%, 3.4%, and 2.2%, respectively 34 .…”

“… 32 A Japanese study also demonstrated a prevalence for PTFV1 of 4.9%. 33 In another Finnish cohort, incidence rates for prolonged P‐wave duration, abnormal PTFV1, left P‐wave axis deviation, and right P‐wave axis deviation were found to be 16.0%, 7.4%, 3.4%, and 2.2%, respectively. 34 In the large Atherosclerosis Risk in Communities (ARIC) study, the prevalence of abnormal P‐wave axis was comparable at 8.3%.…”

Lone Atrial Fibrillation Reconfirmed as Unfavorable Arrhythmia

“…For example, a recent NIPPON DATA 2010 study showed that a subtle increase in serum B-type natriuretic peptide (BNP) was linked to electrocardiographic P-wave terminal force in lead V1 observed at baseline 7) . The linkage between electrocardiographic P-wave terminal force in lead V1 and long-term outcomes remains to be confirmed.…”