title: Ability of Reduced Lung Function to Predict Development of Atrial Fibrillation in Persons Aged 45 to 84 Years (from the Multi-Ethnic Study of Atherosclerosis-Lung Study).
abstract: Atrial fibrillation (AF) occurs frequently in patients with chronic obstructive pulmonary disease. Epidemiologic studies have found inconsistent associations between lung function and AF, and none have studied pulmonary emphysema, which overlaps only partially with chronic obstructive pulmonary disease in the general population. The aim of this study was to assess the relation among lung function measured by spirometry, the percentage of emphysema-like lung on computed tomography, and incident AF. The Multi-Ethnic Study of Atherosclerosis (MESA) is a multicenter cohort study following 6,814 subjects free of clinical cardiovascular disease, including AF, at baseline. Spirometry was performed in a subset of 3,965 participants. Percentage emphysema was defined on baseline computed tomographic scans as lung regions <950 Hounsfield units. Incident AF was identified from hospital discharge diagnosis and Medicare claims data. Cox proportional hazards models were used to assess independent associations of lung volumes and percentage emphysema with AF. A total of 3,811 participants with valid spirometric results were included in this study. The mean age was 64.5 ± 9.8 years, and 49.4% were men. AF developed in 149 subjects (3.8%) over a mean follow-up period of 4.1 years after spirometry. Lower levels of forced expiratory volume at 1 second and forced vital capacity were associated with a higher risk for AF (hazard ratios 1.21 and 1.19 per 500 ml, respectively, p <0.001) after adjustment for demographic and cardiovascular risk factors. Percentage emphysema was not significantly related to AF. In conclusion, in a multiethnic community-based sample of subjects free of cardiovascular disease at baseline, functional airflow limitation was related to a higher risk for AF.
authors.affiliation: Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Harjit
authors.initials: H
authors.lastname: Chahal
authors.affiliation: Collaborative Health Studies Coordinating Center, University of Washington, Seattle, Washington.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.affiliation: Department of Epidemiology, Columbia University, New York, New York.
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Department of Cardiology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Aditya
authors.initials: A
authors.lastname: Jain
authors.affiliation: Department of Cardiology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Mohammadali
authors.initials: M
authors.lastname: Habibi
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.affiliation: Department of Epidemiology, Columbia University, New York, New York.
authors.forename: Richard
authors.initials: R
authors.lastname: Kronmal
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.affiliation: Department of Cardiology, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Division of Cardiology, University of California, Los Angeles, School of Medicine, Los Angeles, California.
authors.forename: Karol E
authors.initials: KE
authors.lastname: Watson
authors.affiliation: Department of Preventive Medicine, Northwestern University Medical School, Chicago, Illinois.
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Pulmonary Medicine, Northwestern University Medical School, Chicago, Illinois.
authors.forename: Lewis J
authors.initials: LJ
authors.lastname: Smith
authors.affiliation: Department of Preventive Medicine, Northwestern University Medical School, Chicago, Illinois. Electronic address: p-greenland@northwestern.edu.
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000208:ethnology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011656:Pulmonary Emphysema / Q000208:ethnology / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012720:Severity of Illness Index