scholarly journals Association of Holter-based measures including T-wave alternans with risk of sudden cardiac death in the community-dwelling elderly: the Cardiovascular Health Study

2010 ◽  
Vol 43 (3) ◽  
pp. 251-259 ◽  
Author(s):  
Phyllis K. Stein ◽  
Devang Sanghavi ◽  
Nona Sotoodehnia ◽  
David S. Siscovick ◽  
John Gottdiener
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Cardiovascular Health ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
T Wave ◽  
T Wave Alternans

Inflammation and sudden cardiac death in a community-based population of older adults: The Cardiovascular Health Study

Heart Rhythm ◽  
2013 ◽  
Vol 10 (10) ◽  
pp. 1425-1432 ◽  
Author(s):  
Ayman A. Hussein ◽  
John S. Gottdiener ◽  
Traci M. Bartz ◽  
Nona Sotoodehnia ◽  
Christopher DeFilippi ◽  
...  
Keyword(s):  
Older Adults ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Community Based

Abstract 30: Global Electrical Heterogeneity on Electrocardiogram is Associated with Sudden Cardiac Death After Adjustment for Ejection Fraction

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Larisa G Tereshchenko ◽  
Jonathan Waks ◽  
Mary Biggs ◽  
Colleen Sitlani ◽  
Muammar Kabir ◽  
...  
Keyword(s):  
Older Adults ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Cardiovascular Health ◽  
Cox Regression ◽  
Middle Age ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Conduction Delay ◽  
Delay Model

Introduction: Electrocardiographic (ECG) measures of myocardial global electrical heterogeneity (GEH) are associated with sudden cardiac death (SCD) in middle-age adults. Hypothesis: We hypothesized that time-updated ECG GEH measures are associated with SCD in elderly adults after LVEF adjustment. Methods: We analyzed data from 2 prospective cohorts: The Atherosclerosis Risk in Communities (ARIC, n=15,366; mean age 54.1±5.8 y; 44.6% male; 73.2% white) and the Cardiovascular Health Study (CHS, n=5,016; mean age 72.8±5.6 y; 43.1% male; 95.3% white). Mean spatial QRS-T angle, azimuth, elevation, and magnitude of spatial ventricular gradient (SVG), and sum absolute QRST integral (SAI QRST) were calculated from digital 12-lead ECGs and analyzed as baseline variables in ARIC and as time-updated longitudinal variables in CHS (measured yearly at 10 consecutive visits). The primary outcome was adjudicated SCD. Cox regression models were constructed: Model 1 adjusted for age, sex and race. Model 2 further adjusted for cardiovascular disease, beta-blocker use, creatinine, BMI, hypertension, diabetes, smoking, total cholesterol, HDL, triglycerides, physical activity and alcohol use. Model 3 included Model 2 variables and heart rate, QTc, LV hypertrophy and bundle branch block or intra-ventricular conduction delay. Model 4 in CHS included all Model 3 variables plus baseline LVEF and time-updated incident HF and coronary heart disease. Results: During median 13-14 y of follow-up SCD incidence was 1.51 (95%CI 1.35-1.69) per 1,000 person-yrs in ARIC, and 2.78 (95%CI 2.41-3.21) per 1,000 person-yrs in CHS. In both cohorts (Table) QRS-T angle, SVG and SAI QRST were associated with SCD. Among older adults (CHS), longitudinal SAI QRST, QRS-T angle and SVG magnitude were associated with SCD independent of LVEF. Conclusions: Baseline and longitudinal GEH ECG parameters are independently associated with SCD in middle-age and older adults, respectively. In older adults, GEH ECG parameters provide information on SCD risk beyond LVEF.

scholarly journals N-terminal pro-B-type natriuretic peptide is associated with sudden cardiac death risk: the Cardiovascular Health Study

Heart Rhythm ◽  
2011 ◽  
Vol 8 (2) ◽  
pp. 228-233 ◽  
Author(s):  
Kristen K. Patton ◽  
Nona Sotoodehnia ◽  
Christopher DeFilippi ◽  
David S. Siscovick ◽  
John S. Gottdiener ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Natriuretic Peptide ◽  
Cardiac Death ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Death Risk ◽  
Sudden Cardiac Death Risk

Abstract P027: Time-updated Premature Ventricular Contractions on 12-lead ECG Are Associated With the Risk of Sudden Cardiac Death: Atherosclerosis Risk in Communities Study and Cardiovascular Health Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Abhishek Maan ◽  
David M German ◽  
Aron Bender ◽  
Srini V Mukundan ◽  
Colleen Sitlani ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Cardiovascular Health ◽  
Competing Risk ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Premature Ventricular Contractions ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Introduction: The association between premature ventricular contractions (PVCs) and Sudden Cardiac Death (SCD) remains controversial. Hypothesis: We hypothesized that PVCs are associated with SCD. Methods: Presence of PVCs was detected on 12-lead ECG recorded at baseline or any of 4 follow-up visits in 15,667 participants (pts) (mean age: 54.2 + 5.8 Yrs; 55% female; 73% Whites) of the Atherosclerosis Risk in Communities (ARIC) study. For validation cohort, we included baseline and 9 follow-up visits ECG data in 5,846 pts (mean age: 72.8+ 5.6 yrs; 57.7% female, 84.2% whites) from Cardiovascular Health Study (CHS). Competing risk analyses models were constructed to test the association between time-updated PVCs and SCD risk. Model 1 was adjusted for age, sex, race and study center. Model 2 in addition was adjusted for time-updated coronary heart disease, heart failure, atrial fibrillation, stroke, and hypertension. Results: In ARIC pts, across all study visits, PVCs were observed in 2.6% of the ECGs; 99.7% of pts were PVC-free at least once; 8.8% of pts had PVC at least once. 97.7% of pts without PVCs remained PVC-free at the next visit; 19.1% of pts with detected PVC had PVC at the next visit; 2.4% of pts who were PVC-free on previous ECG, transitioned to having PVC on subsequent visit ECG. In CHS, across all 10 yearly study visits, on average, PVC was observed on 4.85% of ECG recordings; 99.4% of participants were PVC-free at least once; 21.9% of pts had PVC at least once. 96.4% of PVC-free pts remained free from PVC at the next visit. 30.6% of pts with detected PVC on a given ECG had PVC at the next visit. 3.6% of pts who did not have PVC on previous ECG, transitioned to having PVC at the next visit. 69.4% of pts with PVC on a given ECG transitioned to being PVC-free next year. In adjusted competing risk analysis PVC was associated with SCD, but not with non-sudden cardiac death or non-cardiac death (Table). Conclusions: Time-updated presence of PVC on a short 10-sec resting 12-lead ECG is associated with SCD.

RESEARCH THE VALUE OF THE COMBINATION OF T WAVE ALTERNANS AND NT-PROBNT IN PREDICTING SUDDEN CARDIAC DEATH

2012 ◽  
pp. 74-83
Author(s):  
Anh Tien Hoang ◽  
Nhat Quang Nguyen
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Healthy Person ◽  
Treadmill Test ◽  
T Wave ◽  
T Wave Alternans

Background: Decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-to-bedside foundation makes TWA, NT-ProBNP a very plausible index of susceptibility to ventricular arrythmia, and motivates the need to define optimal combination of TWA and NT-ProBNP in predicting ventricular arrythmia in myocardial infarction patients. We research this study with 2 targets: 1. To evaluate the role of TWA in predicting sudden cardiac death in myocardial infarction patients. 2. To evaluate the role of NT-ProBNP in predicting sudden cardiac death in myocardial infarction patients 3. Evaluate the role of the combined NT-ProBNP and TWA in predicting sudden cardiac death in myocardial infarction patients. Methods: Prospective study with follow up the mortality in 2 years: 71 chronic myocardial infarction patients admitted to hospital from 5/2009 to 5/20011 and 50 healthy person was done treadmill test to caculate TWA; ECG, echocardiography, NT-ProBNP. Results: Cut-off point of NT-ProBNP in predicting sudden cardiac death is 3168 pg/ml; AUC = 0,86 (95% CI: 0,72 - 0,91); Cut-off point of TWA in predicting sudden cardiac death is 107 µV; AUC = 0,81 (95% CI: 0,69 - 0,87); NT-ProBNP can predict sudden cardiac death with OR= 7,26 (p<0,01); TWA can predict sudden cardiac death with OR= 8,45 (p<0,01). The combined NT-ProBNP and TWA in predicting ventricular arrythmia in heart failure patients: OR= 17,91 (p<0,001). Conclusions: The combined NT-ProBNP and TWA have the best predict value of sudden cardiac death in myocardial infarction patients, compare to NT-ProBNP or TWA alone

scholarly journals Left atrial diameter and vascular brain injury on MRI

Neurology ◽  
2018 ◽  
Vol 91 (13) ◽  
pp. e1237-e1244 ◽  
Author(s):  
Shadi Yaghi ◽  
Traci M. Bartz ◽  
Richard Kronmal ◽  
Hooman Kamel ◽  
John Gottdiener ◽  
...  
Keyword(s):  
Brain Injury ◽  
Left Atrial ◽  
Cardiovascular Health ◽  
Brain Mri ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Linear Regression Models ◽  
Left Atrial Diameter ◽  
Brain Infarcts

ObjectiveTo determine the association left atrial diameter (LAD) and vascular brain injury on brain MRI.MethodsWe analyzed data from the Cardiovascular Health Study (CHS), a prospective cohort of community-dwelling adults ≥65 years old. LAD was measured from 2-dimensional transthoracic echocardiograms. Among CHS participants who underwent brain MRI, we examined associations of LAD with brain infarcts and leukoaraiosis. Primary outcomes (number for analysis) were prevalent infarcts (2,327) and degree of leukoaraiosis on initial MRI (2,315). Secondary outcomes were prevalent nonlacunar infarcts (2,327), incident infarcts (939), incident nonlacunar infarcts (1,185), and degree of leukoaraiosis on follow-up MRI adjusted for initial MRI (1,158). Relative risk (RR) and linear regression models were adjusted for demographics, vascular risk factors, and potential confounders.ResultsMean age of the 2,335 participants with initial brain MRI was 72.0 ± 4.8 years; 38.7% were men; and 29.0% participants had prevalent infarcts. In multivariable, fully adjusted models, LAD was associated with prevalent infarcts (RR 1.20, 95% confidence interval [CI] 1.08–1.34) and prevalent nonlacunar infarcts (RR 1.28, 95% CI 1.06–1.54) but not with leukoaraiosis (−0.08, 95% CI −0.17 to 0.07), incident infarcts (RR 1.00, 95% CI 0.78–1.29), nonlacunar infarcts (RR 0.98, 95% CI 0.67–1.42), or worsening leukoaraiosis (−0.04, 95% CI −0.10 to 0.02).ConclusionLAD is independently associated with prevalent brain infarcts, particularly nonlacunar infarcts, but not leukoaraiosis. Larger studies are needed to determine associations with incident infarct risk and whether this risk in patients with left atrial enlargement can be reduced with anticoagulant agents.

HOW DO COMMUNITY PHYSICAL AND OCCUPATIONAL THERAPISTS CLASSIFY FRAILTY? A PILOT STUDY

2014 ◽  
pp. 1-4
Author(s):  
K.P. ROLAND ◽  
O. THEOU ◽  
J.M. JAKOBI ◽  
L. SWAN ◽  
G.R. JONES
Keyword(s):  
Cardiovascular Health ◽  
Healthcare Professionals ◽  
Frailty Index ◽  
Occupational Therapists ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Geriatric Syndrome ◽  
Dimensional Approach

Background: Frailty is a complex geriatric syndrome that is often difficult to diagnose, especially by healthcare professionals working in the community. Objectives, Measurements: This study examined how physical and occupational therapists classified community-dwelling clients using categories of ‘nonfrail’, ‘prefrail’ or ‘frail’ as compared to measurements of established frailty criteria from the Cardiovascular Health Study frailty index (CHSfi). Results: Results indicate that community therapists underestimate frailty in comparison to the CHSfi. Therapists’ classification of frailty suggested their perceptions of frailty may not only relate to client’s functional capacity, but the context in which the client receives care. Conclusion: A multi-dimensional approach is required to capture all aspects of frailty across the healthcare continuum that accounts for how the client thrives within their personal environment.

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