{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T11:13:26Z","timestamp":1783768406833,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K24HL148521"],"award-info":[{"award-number":["K24HL148521"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recent evidence indicates that abnormal P\u2010wave parameters (PWPs)\u2014ECG markers of atrial myopathy\u2014are associated with incident dementia, independent of atrial fibrillation (AF) and clinical ischemic stroke. However, the mechanisms remain unclear and may include subclinical vascular brain injury. Hence, we evaluated the association of abnormal PWPs with brain MRI correlates of vascular brain injury in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC\u2010NCS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>ARIC\u2010NCS participants who underwent 3T brain MRI scans in 2011\u20132013 were included. PWPs were measured from standard 12\u2010lead ECGs. Brain MRI outcomes included cortical infarcts, lacunar infarcts, cerebral microhemorrhages, brain volumes, and white matter disease (WMD) volume. We used weighted multivariable logistic and linear regression to evaluate the associations of abnormal PWPs with brain MRI outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1715 participants (mean age, 76.1 years; 61% women; 29% Black), 797 (46%) had \u22651 abnormal PWP. After multivariable adjustment, including adjusting for prevalent AF, abnormal P\u2010wave terminal force in lead V1 (aPTFV1) and prolonged P\u2010wave duration (PPWD) were associated with increased odds of both cortical (OR 1.41; 95% CI, 1.14 to 1.74 and OR 1.30; 95% CI, 1.04 to 1.63, respectively) and lacunar infarcts (OR 1.36; 95% CI, 1.15 to 1.63 and OR 1.37; 95% CI, 1.15 to 1.65, respectively). Advanced interatrial block (aIAB) was associated with higher odds of subcortical microhemorrhage (OR 2.04; 95% CI, 1.36 to 3.06). Other than a significant association between aPTFV1 with lower parietal lobe volume, there were no other significant associations with brain or WMD volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this exploratory analysis of a US community\u2010based cohort, ECG surrogates of atrial myopathy are associated with a higher prevalence of brain infarcts and microhemorrhage, suggesting subclinical vascular brain injury as a possible mechanism underlying the association of atrial myopathy with dementia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14687","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T10:26:26Z","timestamp":1678962386000},"page":"951-959","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Association of abnormal p\u2010wave parameters with brain MRI morphology: The atherosclerosis risk in communities neurocognitive study (ARIC\u2010NCS)*"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9180-0016","authenticated-orcid":false,"given":"Jorge L.","family":"Reyes","sequence":"first","affiliation":[{"name":"Lillehei Heart Institute and Cardiovascular Division Department of Medicine University of Minnesota Medical School  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faye L.","family":"Norby","sequence":"additional","affiliation":[{"name":"Center for Cardiac Arrest Prevention Department of Cardiology Cedars\u2010Sinai Smidt Heart Institute  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuekai","family":"Ji","sequence":"additional","affiliation":[{"name":"Lillehei Heart Institute and Cardiovascular Division Department of Medicine University of Minnesota Medical School  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6025-0173","authenticated-orcid":false,"given":"Wendy","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romil","family":"Parikh","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2537-2831","authenticated-orcid":false,"given":"Michael J.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Lillehei Heart Institute and Cardiovascular Division Department of Medicine University of Minnesota Medical School  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niki C.","family":"Oldenburg","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela L.","family":"Lutsey","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Clifford R.","family":"Jack","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca F.","family":"Gottesman","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Coresh","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Mosley","sequence":"additional","affiliation":[{"name":"The Memory Impairment and Neurodegenerative Dementia Center University of Mississippi Medical Center  Jackson Mississippi USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsayed Z.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Division of Public Health Sciences Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Alonso","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin Yee","family":"Chen","sequence":"additional","affiliation":[{"name":"Lillehei Heart Institute and Cardiovascular Division Department of Medicine University of Minnesota Medical School  Minneapolis Minnesota 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