This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2005.11.068v1 47/8/1683    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (6) Citing Articles via Google Scholar Google Scholar Articles by Hanna, I. R. Articles by Langberg, J. J. Search for Related Content PubMed PubMed Citation Articles by Hanna, I. R. Articles by Langberg, J. J.

CLINICAL RESEARCH: CARDIAC RHYTHM DISORDER

The Relationship Between Stature and the Prevalence of Atrial Fibrillation in Patients With Left Ventricular Dysfunction

Ibrahim R. Hanna, MD^_*,_*, Brian Heeke, BS^_*, Heather Bush, MS, Lynne Brosius, MS, Diane King-Hageman, BS, John F. Beshai, MD^_* and Jonathan J. Langberg, MD^_*

^_* Division of Cardiology, Section of Electrophysiology, Emory University, Atlanta, Georgia
REGISTRAT Inc., Lexington, Kentucky.

Manuscript received October 13, 2005; revised manuscript received November 14, 2005, accepted November 16, 2005.

^_* Reprint requests and correspondence: Dr. Ibrahim R. Hanna, Emory University Hospital, 1364 Clifton Road, Suite F414, Atlanta, Georgia 30322. (Email: ihanna2{at}aol.com).

OBJECTIVES: This study sought to determine the influence of stature on atrial fibrillation (AF) in high-risk patients with reduced left ventricular (LV) systolic function.

BACKGROUND: Left atrial (LA) enlargement is a potent risk factor for AF. Because LA size is strongly associated with stature, we hypothesized that height and body surface area (BSA) are risk factors for AF, independent of other known associations.

METHODS: Data were obtained from ADVANCENT, a multicenter registry of patients with impaired LV function. Height and BSA were divided into quartiles by gender. Statistical analysis was done using the Cochran Mantel-Haenszel statistic, and multivariable logistic regressions were used to adjust for the effects of known confounders on the association between stature and AF.

RESULTS: A total of 25,268 patients were enrolled. The mean age was 66 years, and the cohort consisted mostly of white men (72%) and patients with ischemic cardiomyopathy (72%). The mean left ventricular ejection fraction was 31%. A history of AF was present in 7,027 patients (27.8%). The AF prevalence increased significantly between the lowest and highest quartiles for height (32% relative increase, p < 0.0001). In the multivariable analysis, the effect of height on AF risk persisted after adjusting for age, gender, race, left ventricular ejection fraction, heart failure class and etiology, hypertension, diabetes, and medication use (odds ratio 1.026/cm, 95% confidence interval [CI] 1.022 to 1.030). In the multivariable analysis, BSA was also an independent predictor of AF risk (odds ratio 4.221/m², 95% CI 3.358 to 5.306).

CONCLUSIONS: In patients with LV dysfunction, increasing stature portends a higher risk of AF independent of other traditional risk factors for the arrhythmia. This association seems to account for the higher prevalence of AF in men and may be useful for identification of a high-risk population.

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   AF = atrial fibrillation   ARB = angiotensin receptor blockers   BMI = body mass index   BSA = body surface area   LA = left atrial   LV = left ventricular   LVEF = left ventricular ejection fraction   NYHA = New York Heart Association

This article has been cited by other articles:

				A. Rosengren, P. J. Hauptman, G. Lappas, L. Olsson, L. Wilhelmsen, and K. Swedberg Big men and atrial fibrillation: effects of body size and weight gain on risk of atrial fibrillation in men Eur. Heart J., May 1, 2009; 30(9): 1113 - 1120. [Abstract] [Full Text] [PDF]

				L. Mont, R. Elosua, and J. Brugada Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter Europace, January 1, 2009; 11(1): 11 - 17. [Abstract] [Full Text] [PDF]

				L. Mont, D. Tamborero, R. Elosua, I. Molina, B. Coll-Vinent, M. Sitges, B. Vidal, A. Scalise, A. Tejeira, A. Berruezo, et al. Physical activity, height, and left atrial size are independent risk factors for lone atrial fibrillation in middle-aged healthy individuals Europace, January 4, 2008; (2008) eum263v1. [Abstract] [Full Text] [PDF]

				S. Y Tan, J. Myers, and V. F Froelicher Abstract 2115: Relationship Between Stature and the Prevalence of Atrial Fibrillation and Cardiovascular Mortality Circulation, October 31, 2006; 114(18_MeetingAbstracts): II_429 - II_429.