Faye L Norby1, Alvaro Alonso2, Mary R Rooney2, Ankit Maheshwari2, Ryan J Koene2, Michael Zhang2, Elsayed Z Soliman2, Laura R Loehr2, Thomas Mosley2, Rebecca F Gottesman2, Josef Coresh2, Lin Y Chen2. 1. From the Division of Epidemiology and Community Health (F.L.N.), School of Public Health, University of Minnesota, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Department of Epidemiology (M.R.R., J.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Penn State Heart and Vascular Institute (A.M.), Penn State College of Medicine, Hershey, PA; Aultman Medical Group (R.J.K.), Aultman Hospital, Canton, OH; Cardiac Arrhythmia Center (M.Z., L.Y.C.), Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis; Department of Epidemiology (E.Z.S.), Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Medicine (L.R.L.), School of Medicine, University of North Carolina at Chapel Hill; Department of Medicine (T.M.), University of Mississippi Medical Center, Jackson; and Departments of Neurology and Epidemiology (R.F.G.), Johns Hopkins University, Baltimore, MD flopez@umn.edu. 2. From the Division of Epidemiology and Community Health (F.L.N.), School of Public Health, University of Minnesota, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Department of Epidemiology (M.R.R., J.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Penn State Heart and Vascular Institute (A.M.), Penn State College of Medicine, Hershey, PA; Aultman Medical Group (R.J.K.), Aultman Hospital, Canton, OH; Cardiac Arrhythmia Center (M.Z., L.Y.C.), Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis; Department of Epidemiology (E.Z.S.), Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Medicine (L.R.L.), School of Medicine, University of North Carolina at Chapel Hill; Department of Medicine (T.M.), University of Mississippi Medical Center, Jackson; and Departments of Neurology and Epidemiology (R.F.G.), Johns Hopkins University, Baltimore, MD.
Abstract
OBJECTIVE: We performed a cross-sectional analysis to determine whether nonsustained ventricular tachycardia (NSVT) and premature ventricular contractions (PVCs) were associated with dementia in a population-based study. METHODS: We included 2,517 (mean age 79 years, 26% Black) participants who wore a 2-week ambulatory continuous ECG recording device in 2016 to 2017. NSVT was defined as a wide-complex tachycardia ≥4 beats with a rate >100 bpm. We calculated NSVT and PVC burden as the number of episodes per day. Dementia was adjudicated by experts. We used logistic regression to assess the associations of NSVT and PVCs with dementia. RESULTS: The mean recording time of the Zio XT Patch was 12.6 ± 2.6 days. There were 768 (31%) participants with NSVT; prevalence was similar in White and Black participants. There were 134 (6.5%) dementia cases (5% in White, 10% in Black participants). After multivariable adjustment, there was no overall association between NSVT and dementia; however, there was a significant race interaction (p < 0.001). In Black participants, NSVT was associated with a 3.67 times higher adjusted odds of dementia (95% confidence interval [CI] 1.92-7.02) compared to those without NSVT, whereas in White participants NSVT was not associated with dementia (odds ratio [95% CI] 0.64 [0.37-1.10]). In Black participants only, a higher burden of PVCs was associated with dementia. CONCLUSIONS: Presence of NSVT and a higher burden of NSVT and PVCs are associated with dementia in elderly Black people. Further research to confirm this novel finding and to elucidate the underlying mechanisms is warranted.
OBJECTIVE: We performed a cross-sectional analysis to determine whether nonsustained ventricular tachycardia (NSVT) and premature ventricular contractions (PVCs) were associated with dementia in a population-based study. METHODS: We included 2,517 (mean age 79 years, 26% Black) participants who wore a 2-week ambulatory continuous ECG recording device in 2016 to 2017. NSVT was defined as a wide-complex tachycardia ≥4 beats with a rate >100 bpm. We calculated NSVT and PVC burden as the number of episodes per day. Dementia was adjudicated by experts. We used logistic regression to assess the associations of NSVT and PVCs with dementia. RESULTS: The mean recording time of the Zio XT Patch was 12.6 ± 2.6 days. There were 768 (31%) participants with NSVT; prevalence was similar in White and Black participants. There were 134 (6.5%) dementia cases (5% in White, 10% in Black participants). After multivariable adjustment, there was no overall association between NSVT and dementia; however, there was a significant race interaction (p < 0.001). In Black participants, NSVT was associated with a 3.67 times higher adjusted odds of dementia (95% confidence interval [CI] 1.92-7.02) compared to those without NSVT, whereas in White participants NSVT was not associated with dementia (odds ratio [95% CI] 0.64 [0.37-1.10]). In Black participants only, a higher burden of PVCs was associated with dementia. CONCLUSIONS: Presence of NSVT and a higher burden of NSVT and PVCs are associated with dementia in elderly Black people. Further research to confirm this novel finding and to elucidate the underlying mechanisms is warranted.
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