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Article: Abnormal vascular function in PR-interval prolongation
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TitleAbnormal vascular function in PR-interval prolongation
 
AuthorsChan, YH1
Siu, CW1
Yiu, KH1
Li, SW2 1
Lau, KK1
Lam, TH1
Lau, CP1
Tse, HF1
 
Issue Date2011
 
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
 
CitationClinical Cardiology, 2011, v. 34 n. 10, p. 628-632 [How to Cite?]
DOI: http://dx.doi.org/10.1002/clc.20958
 
AbstractBackground: Underlying mechanisms of PR-interval prolongation leading to increased risk of adverse cardiovascular outcomes, including atrial fibrillation, are unclear. This study aims to investigate the relation between PR interval and changes in vascular function. Hypothesis: We hypothesize that there exists an intermediate pathological stage between electrocardiographic PR prolongation and adverse cardiovascular outcomes, which could be reflected by changes in surrogate measurements of vascular function. Methods: We recruited 88 healthy subjects (mean age 57.5 ± 9.8 y, 46% male) from a community-based health screening program who had no history of cardiovascular disease or diabetes mellitus. PR interval was determined from a resting 12-lead electrocardiogram. Vascular function was noninvasively assessed by flow-mediated dilation (FMD) using high-resolution ultrasound and brachial-ankle pulse wave velocity (PWV) using a vascular profiling system. Results: Only 3 subjects had a PR-interval length longer than the conventional cutoff of 200 ms. The PR-interval length was associated inversely with FMD (Pearson r = -0.30, P = 0.004) and positively with PWV (r = 0.40, P < 0.001). Adjusting for potential confounders, increased PR-interval length by each 25 ms was independently associated with reduced FMD by -1 unit (absolute %, B = -0.04 [95% confidence interval: -0.080 to -0.002, P = 0.040)] and increased PWV by +103 cm/second (B = +4.1 [95% confidence interval: 0.6-7.6, P = 0.023]). Conclusions: This study shows that PR-interval length, even in the conventionally normal range, is independently associated with endothelial dysfunction and increased arterial stiffness in healthy subjects free of atherosclerotic disease. This suggests the presence of a systemic, intermediate pathologic stage of the vasculature in PR prolongation before clinically manifest cardiovascular events, and could represent a mediating mechanism. © 2011 Wiley Periodicals, Inc.
 
ISSN0160-9289
2013 Impact Factor: 2.225
2013 SCImago Journal Rankings: 1.003
 
DOIhttp://dx.doi.org/10.1002/clc.20958
 
ISI Accession Number IDWOS:000296191700008
Funding AgencyGrant Number
University of Hong Kong200907176063
Sun Chieh Yeh Heart Foundation, Hong Kong, China
Funding Information:

This study was supported by the CRCG Small Project Funding of the University of Hong Kong (Project No. 200907176063) and the Sun Chieh Yeh Heart Foundation, Hong Kong, China. Yap-Hang received a Best Paper Award at the Third Asian Preventive Cardiology and Cardiac Rehabilitation Conference, Hong Kong, China, December 11-12, 2010. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorChan, YH
 
dc.contributor.authorSiu, CW
 
dc.contributor.authorYiu, KH
 
dc.contributor.authorLi, SW
 
dc.contributor.authorLau, KK
 
dc.contributor.authorLam, TH
 
dc.contributor.authorLau, CP
 
dc.contributor.authorTse, HF
 
dc.date.accessioned2011-12-21T08:54:13Z
 
dc.date.available2011-12-21T08:54:13Z
 
dc.date.issued2011
 
dc.description.abstractBackground: Underlying mechanisms of PR-interval prolongation leading to increased risk of adverse cardiovascular outcomes, including atrial fibrillation, are unclear. This study aims to investigate the relation between PR interval and changes in vascular function. Hypothesis: We hypothesize that there exists an intermediate pathological stage between electrocardiographic PR prolongation and adverse cardiovascular outcomes, which could be reflected by changes in surrogate measurements of vascular function. Methods: We recruited 88 healthy subjects (mean age 57.5 ± 9.8 y, 46% male) from a community-based health screening program who had no history of cardiovascular disease or diabetes mellitus. PR interval was determined from a resting 12-lead electrocardiogram. Vascular function was noninvasively assessed by flow-mediated dilation (FMD) using high-resolution ultrasound and brachial-ankle pulse wave velocity (PWV) using a vascular profiling system. Results: Only 3 subjects had a PR-interval length longer than the conventional cutoff of 200 ms. The PR-interval length was associated inversely with FMD (Pearson r = -0.30, P = 0.004) and positively with PWV (r = 0.40, P < 0.001). Adjusting for potential confounders, increased PR-interval length by each 25 ms was independently associated with reduced FMD by -1 unit (absolute %, B = -0.04 [95% confidence interval: -0.080 to -0.002, P = 0.040)] and increased PWV by +103 cm/second (B = +4.1 [95% confidence interval: 0.6-7.6, P = 0.023]). Conclusions: This study shows that PR-interval length, even in the conventionally normal range, is independently associated with endothelial dysfunction and increased arterial stiffness in healthy subjects free of atherosclerotic disease. This suggests the presence of a systemic, intermediate pathologic stage of the vasculature in PR prolongation before clinically manifest cardiovascular events, and could represent a mediating mechanism. © 2011 Wiley Periodicals, Inc.
 
dc.description.naturelink_to_OA_fulltext
 
dc.identifier.citationClinical Cardiology, 2011, v. 34 n. 10, p. 628-632 [How to Cite?]
DOI: http://dx.doi.org/10.1002/clc.20958
 
dc.identifier.doihttp://dx.doi.org/10.1002/clc.20958
 
dc.identifier.eissn1932-8737
 
dc.identifier.epage632
 
dc.identifier.hkuros197998
 
dc.identifier.isiWOS:000296191700008
Funding AgencyGrant Number
University of Hong Kong200907176063
Sun Chieh Yeh Heart Foundation, Hong Kong, China
Funding Information:

This study was supported by the CRCG Small Project Funding of the University of Hong Kong (Project No. 200907176063) and the Sun Chieh Yeh Heart Foundation, Hong Kong, China. Yap-Hang received a Best Paper Award at the Third Asian Preventive Cardiology and Cardiac Rehabilitation Conference, Hong Kong, China, December 11-12, 2010. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

 
dc.identifier.issn0160-9289
2013 Impact Factor: 2.225
2013 SCImago Journal Rankings: 1.003
 
dc.identifier.issue10
 
dc.identifier.pmid21994083
 
dc.identifier.scopuseid_2-s2.0-80054093737
 
dc.identifier.spage628
 
dc.identifier.urihttp://hdl.handle.net/10722/143767
 
dc.identifier.volume34
 
dc.languageeng
 
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
 
dc.publisher.placeUnited States
 
dc.relation.ispartofClinical Cardiology
 
dc.relation.referencesReferences in Scopus
 
dc.rightsClinical Cardiology (Hoboken). Copyright © John Wiley & Sons, Inc..
 
dc.subject.meshAtrioventricular Block - complications - diagnosis - physiopathology
 
dc.subject.meshBrachial Artery - physiopathology - ultrasonography
 
dc.subject.meshCardiovascular Diseases - etiology - physiopathology
 
dc.subject.meshElectrocardiography
 
dc.subject.meshVasodilation
 
dc.titleAbnormal vascular function in PR-interval prolongation
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Tung Wah Hospital