Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation

Gami, Apoor S.; Hodge, Danielle; Herges, Regina M.; Olson, Eric J.; Nykodým, Jiří; Kára, Tomáš; Somers, Virend K.

doi:10.1016/j.jacc.2006.08.060

Cited by 946 publications

(624 citation statements)

References 38 publications

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“…Higher BMI is associated with inflammation, which is reflected in higher concentrations of C‐reactive protein 37. In addition, general obesity is a major risk factor for obstructive sleep apnea; sleep apnea predisposes to AF 30. Finally, general obesity predisposes to the intermediate occurrence of hypertension, diabetes mellitus, acute MI, heart failure, and heart valve disease, which in turn increase the risk of AF 38…”

Section: Discussionmentioning

confidence: 99%

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Baek

Yang

Kim

et al. 2017

JAHA

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BackgroundHigher height and weight are known to be associated with higher risk of atrial fibrillation (AF); however, whether the risk of AF is related to abdominal obesity is unclear.Methods and ResultsWe studied 501 690 adults (mean age: 47.6±14.3 years; 250 664 women [50.0%]) without baseline AF in the National Sample Cohort released by the National Health Insurance Service in Korea. Body mass index (underweight defined as <18.5; normal, 18.5 to <25.0; overweight, 25.0 to <30.0; and obese, ≥30.0) and waist circumference (abdominal obesity defined as ≥90 cm for men and ≥80 cm for women) were evaluated. During a mean follow‐up of 3.9±1.3 years, 3443 participants (1432 women [41.6%]) developed AF. In multivariable models adjusted for clinical variables, the AF risk of underweight, overweight, and obese individuals increased by 21% (95% confidence interval, 1.01–1.45, P=0.043), 14% (95% confidence interval, 1.06–1.23, P<0.001), and 52% (95% confidence interval, 1.30–1.78, P<0.001), respectively, compared with those with normal body mass index. AF risk with confounder‐adjusted hazards for abdominal obesity was 18% (95% confidence interval, 1.10–1.27, P<0.001). The increased AF risk was present in abdominally obese individuals regardless of body mass index except for the obese group. In subgroup analysis, abdominal obesity by waist circumference conferred increased risk of new‐onset AF, particularly in participants without comorbidities.ConclusionsAbdominal obesity is an important, potentially modifiable risk factor for AF in nonobese Asian persons. These data suggest that interventions to decrease abdominal obesity may reduce the population burden of AF.

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Section: Discussionmentioning

confidence: 99%

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Baek

Yang

Kim

et al. 2017

JAHA

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“…In addition, obesity, metabolic disorder, and obstructive sleep apnea syndrome have been found to independently increase the risk of AF 27. A variety of factors may damage endothelial cells, including physical injuries, biochemical injuries, and immune‐mediated damage.…”

Section: Discussionmentioning

confidence: 99%

Age‐Dependent Predictive Value of Endothelial Dysfunction for Arrhythmia Recurrence Following Pulmonary Vein Isolation

Matsuzawa

Suleiman

Guddeti

et al. 2016

JAHA

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BackgroundThe mechanisms of atrial fibrillation (AF) are highly divergent. The prevalence of AF increases significantly with age, and underling mechanisms might vary with age. Endothelial dysfunction may be associated with AF and atrial arrhythmia recurrence after catheter ablation. We tested the hypothesis that the impact of endothelial dysfunction on arrhythmia recurrence following catheter ablation is age dependent.Methods and ResultsThis study enrolled 92 participants with AF undergoing catheter ablation. Endothelial function was assessed by peripheral arterial tonometry before ablation, and the natural logarithmic transformation of reactive hyperemia index was calculated. Endothelial dysfunction was defined as a natural logarithmic transformation of reactive hyperemia index <0.618 (median). Participants were followed for atrial tachycardia, flutter, and fibrillation recurrence for a median of 14 months. The mean age was 57±10 years. There was significant interaction between age and endothelial dysfunction in association with recurrence of AF (P=0.029) and any atrial arrhythmia (P=0.015), and the risk associated with endothelial dysfunction for arrhythmia recurrence was higher in younger versus older participants. Participants were divided into 2 age groups at a threshold of 60 years. Among participants aged ≤60 years, multivariate Cox proportional hazards analysis revealed the independent association between endothelial dysfunction and increased risk of arrhythmia recurrence (hazard ratio for AF 4.18 [95% CI 1.33–15.82], P=0.014, and for any atrial arrhythmia 3.62 [95% CI 1.29–11.81], P=0.014). Kaplan–Meier analysis showed that participants with endothelial dysfunction had significantly higher rates of recurrence of AF (P=0.01) and any atrial arrhythmia (P=0.002).ConclusionsThe risk associated with endothelial dysfunction for arrhythmia recurrence following catheter ablation was age dependent and was higher in younger participants.

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“…8 This relationship holds true even after multivariate adjustment for other known risk factors, with 3%–7% increased AF risk per unit increment of body mass index (BMI). 8,276,277,278 Obesity is an important contributor to the burden of AF, explaining one-fifth of all AF cases. 279 …”

Section: Section 3: Modifiable Risk Factors For Af and Impact On Ablamentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

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1,468

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Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation

Abstract: Obesity and the magnitude of nocturnal oxygen desaturation, which is an important pathophysiological consequence of OSA, are independent risk factors for incident AF in individuals <65 years of age.

Cited by 946 publications

References 38 publications

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Age‐Dependent Predictive Value of Endothelial Dysfunction for Arrhythmia Recurrence Following Pulmonary Vein Isolation

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

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