Abstract 18672: Association Between Sleep Disordered Breathing and Electrocardiographic Markers of Atrial Abnormalities: The MESA Study

Abstract

Introduction: Abnormal P wave terminal force in V1 (PTFV1), an electrocardiographic marker of left atrial abnormalities, has been linked to increased risk of atrial fibrillation (AF). Examining the association between sleep disordered breathing (SDB) and PTFV1 might shed light on the potential mechanisms by which SDB increases risk of AF. Methods: A total of 1546 participants (mean age 67.2 (± 8.8) years, 53.4 % women and 63.3 % non-Whites) from the Multi-Ethnic Study of Atherosclerosis (MESA) Exam 5 Sleep ancillary were included in this analysis. PTFV1 was measured from resting standard digital ECG tracings that were automatically processed centrally. Linear and logistic regression analyses were used to examine the cross-sectional associations between measures of SDB (apnea hypopnea index [AHI], obstructive AHI [OAHI] and % time spent with oxygen saturation <90% [% SpO2 90]) and PTFV1. Results: There was a trend of higher PFTV1 values across quartiles of AHI, OAHI and % SpO2 90 (p for trend <0.01 for each). In multivariable linear regression models, the upper quartile of AHI and OAHI measures were associated with higher values of PTFV1 compared with the lower quartile (Table). A 1-SD increase of AHI and OAHI were associated with increased levels of PTFV1 (Table). When PTFV1 was considered as a binary variable (using the cut point of 4000 μV.ms to define abnormality) in logistic regression analysis, AHI and OAHI were also associated with abnormal PTFV1. Conclusion: Severity of SDB, as measured by AHI is associated with subclinical left atrial disease, as measured by PTFV1. This could partially explain the reported association between SDB and AF.