Circulating electrolytes and the prevalence of atrial fibrillation and supraventricular ectopy: The Atherosclerosis Risk in Communities (ARIC) study

Alvaro Alonso; Mary R. Rooney; Lin Y. Chen; Faye L. Norby; Amy K. Saenger; Elsayed Z. Soliman; Wesley T. O'Neal; Katie C. Hootman; Elizabeth Selvin; Pamela L. Lutsey

doi:10.1016/j.numecd.2020.03.010

Circulating electrolytes and the prevalence of atrial fibrillation and supraventricular ectopy: The Atherosclerosis Risk in Communities (ARIC) study

Alvaro Alonso, Mary R. Rooney, Lin Y. Chen, Faye L. Norby, Amy K. Saenger, Elsayed Z. Soliman, Wesley T. O'Neal, Katie C. Hootman, Elizabeth Selvin, Pamela L. Lutsey

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Abstract

Background and aims: Evaluating associations of circulating electrolytes with atrial fibrillation (AF) and burden of supraventricular arrhythmias can give insights into arrhythmia pathogenesis. Methods and results: We conducted a cross-sectional analysis of 6398 participants of the Atherosclerosis Risk in Communities (ARIC) study, ages 71–90, with data on serum electrolytes (magnesium, calcium, potassium, phosphorus, chloride, sodium). Prevalence of AF was determined from electrocardiograms and history of AF hospitalizations. A subset of 317 participants also underwent electrocardiographic recordings for up to 14 days using the Zio® patch. Burden of other supraventricular arrhythmias [premature atrial contractions (PACs), supraventricular tachycardia] was determined with the Zio® patch. We used logistic and linear regression adjusting for potential confounders to determine associations of electrolytes with arrhythmia prevalence and burden. Among 6394 eligible participants, 614 (10%) had AF. Participants in the top quintiles of magnesium [odds ratio (OR) 0.82, 95% confidence interval (CI) 0.62, 1.08], potassium (OR 0.82, 95%CI 0.68, 1.00), and phosphorus (OR 0.73, 95%CI 0.59, 0.89) had lower AF prevalence compared to those in the bottom quintiles. No clear association was found for circulating chloride, calcium or sodium. Higher concentrations of circulating calcium were associated with lower prevalence of PACs in the 12-lead electrocardiogram, while higher concentrations of potassium, chloride and sodium were associated with higher PAC prevalence. Circulating electrolytes were not significantly associated with burden of PACs or supraventricular tachycardia among 317 participants with extended electrocardiographic monitoring. Conclusion: Concentrations of circulating electrolytes present complex associations with selected supraventricular arrhythmias. Future studies should evaluate underlying mechanisms.

Original language	English (US)
Pages (from-to)	1121-1129
Number of pages	9
Journal	Nutrition, Metabolism and Cardiovascular Diseases
Volume	30
Issue number	7
DOIs	https://doi.org/10.1016/j.numecd.2020.03.010
State	Published - Jun 25 2020

Bibliographical note

Funding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts ( HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , HHSN268201700004I ). Electrolyte measurements were supported by National Heart, Lung, and Blood Institute grant U01HL096902 . This work was additionally supported by National Heart, Lung, and Blood Institute grant R01 HL126637 and American Heart Association award 16EIA26410001 (Alonso), and National Heart, Lung, and Blood Institute grants T32 HL007779 (Rooney and Hootman) and K24 HL148521 .

Publisher Copyright:
© 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University

Keywords

Arrhythmia
Atrial fibrillation
Calcium
Electrolytes
Magnesium
Phosphorus
Potassium

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Alonso, A., Rooney, M. R., Chen, L. Y., Norby, F. L., Saenger, A. K., Soliman, E. Z., O'Neal, W. T., Hootman, K. C., Selvin, E., & Lutsey, P. L. (2020). Circulating electrolytes and the prevalence of atrial fibrillation and supraventricular ectopy: The Atherosclerosis Risk in Communities (ARIC) study. Nutrition, Metabolism and Cardiovascular Diseases, 30(7), 1121-1129. https://doi.org/10.1016/j.numecd.2020.03.010

Alonso, A, Rooney, MR, Chen, LY , Norby, FL , Saenger, AK, Soliman, EZ, O'Neal, WT, Hootman, KC, Selvin, E & Lutsey, PL 2020, 'Circulating electrolytes and the prevalence of atrial fibrillation and supraventricular ectopy: The Atherosclerosis Risk in Communities (ARIC) study', Nutrition, Metabolism and Cardiovascular Diseases, vol. 30, no. 7, pp. 1121-1129. https://doi.org/10.1016/j.numecd.2020.03.010

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abstract = "Background and aims: Evaluating associations of circulating electrolytes with atrial fibrillation (AF) and burden of supraventricular arrhythmias can give insights into arrhythmia pathogenesis. Methods and results: We conducted a cross-sectional analysis of 6398 participants of the Atherosclerosis Risk in Communities (ARIC) study, ages 71–90, with data on serum electrolytes (magnesium, calcium, potassium, phosphorus, chloride, sodium). Prevalence of AF was determined from electrocardiograms and history of AF hospitalizations. A subset of 317 participants also underwent electrocardiographic recordings for up to 14 days using the Zio{\textregistered} patch. Burden of other supraventricular arrhythmias [premature atrial contractions (PACs), supraventricular tachycardia] was determined with the Zio{\textregistered} patch. We used logistic and linear regression adjusting for potential confounders to determine associations of electrolytes with arrhythmia prevalence and burden. Among 6394 eligible participants, 614 (10%) had AF. Participants in the top quintiles of magnesium [odds ratio (OR) 0.82, 95% confidence interval (CI) 0.62, 1.08], potassium (OR 0.82, 95%CI 0.68, 1.00), and phosphorus (OR 0.73, 95%CI 0.59, 0.89) had lower AF prevalence compared to those in the bottom quintiles. No clear association was found for circulating chloride, calcium or sodium. Higher concentrations of circulating calcium were associated with lower prevalence of PACs in the 12-lead electrocardiogram, while higher concentrations of potassium, chloride and sodium were associated with higher PAC prevalence. Circulating electrolytes were not significantly associated with burden of PACs or supraventricular tachycardia among 317 participants with extended electrocardiographic monitoring. Conclusion: Concentrations of circulating electrolytes present complex associations with selected supraventricular arrhythmias. Future studies should evaluate underlying mechanisms.",

keywords = "Arrhythmia, Atrial fibrillation, Calcium, Electrolytes, Magnesium, Phosphorus, Potassium",

author = "Alvaro Alonso and Rooney, {Mary R.} and Chen, {Lin Y.} and Norby, {Faye L.} and Saenger, {Amy K.} and Soliman, {Elsayed Z.} and O'Neal, {Wesley T.} and Hootman, {Katie C.} and Elizabeth Selvin and Lutsey, {Pamela L.}",

note = "Funding Information: The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts ( HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , HHSN268201700004I ). Electrolyte measurements were supported by National Heart, Lung, and Blood Institute grant U01HL096902 . This work was additionally supported by National Heart, Lung, and Blood Institute grant R01 HL126637 and American Heart Association award 16EIA26410001 (Alonso), and National Heart, Lung, and Blood Institute grants T32 HL007779 (Rooney and Hootman) and K24 HL148521 . Publisher Copyright: {\textcopyright} 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University",

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TY - JOUR

T1 - Circulating electrolytes and the prevalence of atrial fibrillation and supraventricular ectopy

T2 - The Atherosclerosis Risk in Communities (ARIC) study

AU - Alonso, Alvaro

AU - Rooney, Mary R.

AU - Chen, Lin Y.

AU - Norby, Faye L.

AU - Saenger, Amy K.

AU - Soliman, Elsayed Z.

AU - O'Neal, Wesley T.

AU - Hootman, Katie C.

AU - Selvin, Elizabeth

AU - Lutsey, Pamela L.

N1 - Funding Information: The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts ( HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , HHSN268201700004I ). Electrolyte measurements were supported by National Heart, Lung, and Blood Institute grant U01HL096902 . This work was additionally supported by National Heart, Lung, and Blood Institute grant R01 HL126637 and American Heart Association award 16EIA26410001 (Alonso), and National Heart, Lung, and Blood Institute grants T32 HL007779 (Rooney and Hootman) and K24 HL148521 . Publisher Copyright: © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University

PY - 2020/6/25

Y1 - 2020/6/25

N2 - Background and aims: Evaluating associations of circulating electrolytes with atrial fibrillation (AF) and burden of supraventricular arrhythmias can give insights into arrhythmia pathogenesis. Methods and results: We conducted a cross-sectional analysis of 6398 participants of the Atherosclerosis Risk in Communities (ARIC) study, ages 71–90, with data on serum electrolytes (magnesium, calcium, potassium, phosphorus, chloride, sodium). Prevalence of AF was determined from electrocardiograms and history of AF hospitalizations. A subset of 317 participants also underwent electrocardiographic recordings for up to 14 days using the Zio® patch. Burden of other supraventricular arrhythmias [premature atrial contractions (PACs), supraventricular tachycardia] was determined with the Zio® patch. We used logistic and linear regression adjusting for potential confounders to determine associations of electrolytes with arrhythmia prevalence and burden. Among 6394 eligible participants, 614 (10%) had AF. Participants in the top quintiles of magnesium [odds ratio (OR) 0.82, 95% confidence interval (CI) 0.62, 1.08], potassium (OR 0.82, 95%CI 0.68, 1.00), and phosphorus (OR 0.73, 95%CI 0.59, 0.89) had lower AF prevalence compared to those in the bottom quintiles. No clear association was found for circulating chloride, calcium or sodium. Higher concentrations of circulating calcium were associated with lower prevalence of PACs in the 12-lead electrocardiogram, while higher concentrations of potassium, chloride and sodium were associated with higher PAC prevalence. Circulating electrolytes were not significantly associated with burden of PACs or supraventricular tachycardia among 317 participants with extended electrocardiographic monitoring. Conclusion: Concentrations of circulating electrolytes present complex associations with selected supraventricular arrhythmias. Future studies should evaluate underlying mechanisms.

AB - Background and aims: Evaluating associations of circulating electrolytes with atrial fibrillation (AF) and burden of supraventricular arrhythmias can give insights into arrhythmia pathogenesis. Methods and results: We conducted a cross-sectional analysis of 6398 participants of the Atherosclerosis Risk in Communities (ARIC) study, ages 71–90, with data on serum electrolytes (magnesium, calcium, potassium, phosphorus, chloride, sodium). Prevalence of AF was determined from electrocardiograms and history of AF hospitalizations. A subset of 317 participants also underwent electrocardiographic recordings for up to 14 days using the Zio® patch. Burden of other supraventricular arrhythmias [premature atrial contractions (PACs), supraventricular tachycardia] was determined with the Zio® patch. We used logistic and linear regression adjusting for potential confounders to determine associations of electrolytes with arrhythmia prevalence and burden. Among 6394 eligible participants, 614 (10%) had AF. Participants in the top quintiles of magnesium [odds ratio (OR) 0.82, 95% confidence interval (CI) 0.62, 1.08], potassium (OR 0.82, 95%CI 0.68, 1.00), and phosphorus (OR 0.73, 95%CI 0.59, 0.89) had lower AF prevalence compared to those in the bottom quintiles. No clear association was found for circulating chloride, calcium or sodium. Higher concentrations of circulating calcium were associated with lower prevalence of PACs in the 12-lead electrocardiogram, while higher concentrations of potassium, chloride and sodium were associated with higher PAC prevalence. Circulating electrolytes were not significantly associated with burden of PACs or supraventricular tachycardia among 317 participants with extended electrocardiographic monitoring. Conclusion: Concentrations of circulating electrolytes present complex associations with selected supraventricular arrhythmias. Future studies should evaluate underlying mechanisms.

KW - Arrhythmia

KW - Atrial fibrillation

KW - Calcium

KW - Electrolytes

KW - Magnesium

KW - Phosphorus

KW - Potassium

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Circulating electrolytes and the prevalence of atrial fibrillation and supraventricular ectopy: The Atherosclerosis Risk in Communities (ARIC) study

Abstract

Bibliographical note

Keywords

UN SDGs

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