P‐waves can help identify Black patients prone to developing AFib
Black patients have a lower prevalence of atrial fibrillation (AFib) than white adults, but their outcomes and mortality are worse, so earlier identification of those who may be at higher risk for Afib is seen as a key to improve outcomes. New findings on the subject from the Jackson Heart Study, the largest investigation of cardiovascular disease in Black adults, were published this week in the Journal of the American Heart Association.[1]
Researchers found that using electrocardiograms (ECG), specifically P‐wave indices (PWIs) measures, can show atrial cardiomyopathy, which is associated with an increased risk of AFib and ischemic stroke in Black adults. The P‐wave terminal force in V1 (PTFV1) was independently associated with an increased risk of incident AFib and ischemic stroke. Researchers said these new findings underscore the utility of PTFV1 for enabling earlier detection of atrial cardiomyopathy in this group of patients.
“We now have evidence of a cost-effective way to identify Black adults’ at higher risk,” the paper’s lead author Vidhushei Yogeswaran MD, a cardiologist at the UW Medicine Heart Institute in Seattle, said in a statement.
The research team looked 4,900 participants without AFib at baseline from the Jackson Heart Study. They assessed atrial cardiomyopathy using PWIs from resting 12‐lead ECGs, including PR interval, P‐wave duration, P‐wave axis and P‐wave terminal force in V1. They used Cox proportional hazards models to evaluate associations of PWIs with incident AFib and ischemic stroke, and adjusted for established risk factors.
The patients were tracked for more than 13 years. During that time, 396 participants developed AF, while another 135 experienced ischemic strokes. Increases in PR interval, P‐wave duration and PTFV1 were associated with increased AFib risk, with the strongest association being PTFV1.
"These PWIs were also associated with AFib risk using clinically accepted thresholds. Each increase in PTFV1 was associated with a 22% increased risk of ischemic stroke," Yogeswaran wrote in the study.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]