TY - JOUR
T1 - Association of African Ancestry with Electrocardiographic Voltage and Concentric Left Ventricular Hypertrophy
T2 - The Dallas Heart Study
AU - Alame, Aya J.
AU - Garg, Sonia
AU - Kozlitina, Julia
AU - Ayers, Colby
AU - Peshock, Ronald M
AU - Matulevicius, Susan A
AU - Drazner, Mark H
N1 - Funding Information:
received a T35 grant from the National Heart, Lung, and Blood Institute. Dr Kozlitina has received grants from the National Institutes of Health. Dr Peshock has received grants from the Reynolds Foundation and the National Institutes of Health as well as nonfinancial support from Siemens Medical Systems and Philips Medical Systems. Dr Peshock also owns stock in Astra USA, General Electric, Johnson & Johnson, Merck & Co, and Pfizer. Dr Drazner has received grants from the Reynolds Foundation and the National Institutes of Health. No other disclosures were reported.
Funding Information:
funded by the Donald W. Reynolds Foundation and was partially supported by the National Center for
Funding Information:
Advancing Translational Sciences of the National Institutes of Health under grant UL1TR001105. Ms Alame received support from a T35 grant from the National Heart, Lung, and Blood Institute to the University of Texas Southwestern Medical School. Dr Kozlitina received support from the National Center for Advancing Translational Sciences of the National Institutes of Health and grant UL1TR001105 from the Clinical and Translational Science Awards. Dr Drazner received support from the James M. Wooten Chair in Cardiology at the University of Texas Southwestern Medical School.
Publisher Copyright:
© 2018 American Medical Association. All rights reserved.
PY - 2018/12
Y1 - 2018/12
N2 - Importance: Compared with white individuals, black individuals have increased electrocardiographic voltage and an increased prevalence of concentric left ventricular (LV) hypertrophy. Whether environmental or genetic factors lead to these racial differences is unknown. Objective: To determine whether proportion of genetically determined African ancestry among self-reported black individuals is associated with increased electrocardiographic voltage and concentric LV hypertrophy (LVH). Design, Setting, and Participants: The Dallas Heart Study is a probability-based cohort study of English- or Spanish-speaking Dallas County, Texas, residents, with deliberate oversampling of black individuals. Participants underwent extensive phenotyping, which included electrocardiography (ECG), cardiac magnetic resonance imaging (CMR), and dual-energy radiography absorptiometry (DEXA) at a single center. Participants aged 18 to 65 years who enrolled in the Dallas Heart Study between July 2000 and December 2002, self-identified as black (n = 1251) or white (n = 826), and had ECG, CMR, and DEXA data were included in this analysis. Data were analyzed from June 2017 to September 2018. Exposures: Proportion of African ancestry. Main Outcomes and Measures: Electrocardiographic voltage (12-lead and 9-lead) and markers of concentric LVH as assessed by CMR (LV concentricity 0.67 [LV mass/end-diastolic volume 0.67 ], LV wall thickness [LVWT], and prevalent LVH [defined by LV mass/height 2.7 ]). Results: Of the 2077 participants included in the study, 1138 (54.8%) were women, and the mean (SD) age was 45.2 (9.9) years. Black race and African ancestry were individually associated with increased ECG voltage, LV concentricity 0.67 , LVWT, and prevalent LVH in multivariable analyses adjusting for age, sex, systolic blood pressure, antihypertensive medication use, and body composition. When African ancestry and black race were entered together into multivariable models, African ancestry but not black race remained associated with ECG voltage, LVWT, LV concentricity 0.67 , and prevalent LVH. Among black participants, African ancestry remained associated with these 4 phenotypes (12-lead voltage: β, 0.05; P =.04; LVWT: β, 0.05; P =.02; LV concentricty 0.67 : β, 0.05; P =.045; prevalent LVH: odds ratio, 1.2; 95% CI, 1.03-1.4; P =.02). Conclusions and Relevance: Genetically determined African ancestry was associated with electrocardiographic voltage, measures of concentric LV remodeling, and prevalent LVH. These data support a genetic basis related to African ancestry for the increased prevalence of these cardiovascular traits in black individuals.
AB - Importance: Compared with white individuals, black individuals have increased electrocardiographic voltage and an increased prevalence of concentric left ventricular (LV) hypertrophy. Whether environmental or genetic factors lead to these racial differences is unknown. Objective: To determine whether proportion of genetically determined African ancestry among self-reported black individuals is associated with increased electrocardiographic voltage and concentric LV hypertrophy (LVH). Design, Setting, and Participants: The Dallas Heart Study is a probability-based cohort study of English- or Spanish-speaking Dallas County, Texas, residents, with deliberate oversampling of black individuals. Participants underwent extensive phenotyping, which included electrocardiography (ECG), cardiac magnetic resonance imaging (CMR), and dual-energy radiography absorptiometry (DEXA) at a single center. Participants aged 18 to 65 years who enrolled in the Dallas Heart Study between July 2000 and December 2002, self-identified as black (n = 1251) or white (n = 826), and had ECG, CMR, and DEXA data were included in this analysis. Data were analyzed from June 2017 to September 2018. Exposures: Proportion of African ancestry. Main Outcomes and Measures: Electrocardiographic voltage (12-lead and 9-lead) and markers of concentric LVH as assessed by CMR (LV concentricity 0.67 [LV mass/end-diastolic volume 0.67 ], LV wall thickness [LVWT], and prevalent LVH [defined by LV mass/height 2.7 ]). Results: Of the 2077 participants included in the study, 1138 (54.8%) were women, and the mean (SD) age was 45.2 (9.9) years. Black race and African ancestry were individually associated with increased ECG voltage, LV concentricity 0.67 , LVWT, and prevalent LVH in multivariable analyses adjusting for age, sex, systolic blood pressure, antihypertensive medication use, and body composition. When African ancestry and black race were entered together into multivariable models, African ancestry but not black race remained associated with ECG voltage, LVWT, LV concentricity 0.67 , and prevalent LVH. Among black participants, African ancestry remained associated with these 4 phenotypes (12-lead voltage: β, 0.05; P =.04; LVWT: β, 0.05; P =.02; LV concentricty 0.67 : β, 0.05; P =.045; prevalent LVH: odds ratio, 1.2; 95% CI, 1.03-1.4; P =.02). Conclusions and Relevance: Genetically determined African ancestry was associated with electrocardiographic voltage, measures of concentric LV remodeling, and prevalent LVH. These data support a genetic basis related to African ancestry for the increased prevalence of these cardiovascular traits in black individuals.
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U2 - 10.1001/jamacardio.2018.3804
DO - 10.1001/jamacardio.2018.3804
M3 - Article
C2 - 30427995
AN - SCOPUS:85056890956
SN - 2380-6583
VL - 3
SP - 1167
EP - 1173
JO - JAMA Cardiology
JF - JAMA Cardiology
IS - 12
ER -