Silent brain infarcts impact on cognitive function in atrial fibrillation.

Autor:	Kühne M; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland., Krisai P; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland., Coslovsky M; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland.; Clinical Trial Unit Basel, Department of Clinical Research, University Hospital Basel, Basel, Switzerland., Rodondi N; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Müller A; Department of Cardiology, Triemli Hospital Zürich, Zürich, Switzerland., Beer JH; Department of Medicine, Conatonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Zürich, Switzerland., Ammann P; Department of Cardiology, Kantonsspital St Gallen, St Gallen, Switzerland., Auricchio A; Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland., Moschovitis G; Division of Cardiology, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland., Hayoz D; Department of Internal Medicine, HRF-Hôpital Cantonal Fribourg, Fribourg, Switzerland., Kobza R; Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland., Shah D; Division of Cardiology, Department of Medical Specialities, University Hospital Geneva, Geneva, Switzerland., Stephan FP; Department of Cardiology, Bürgerspital Solothurn, Solothurn, Switzerland., Schläpfer J; Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland., Di Valentino M; Division of Cardiology, Ospedale San Giovanni, Ente Ospedaliero Cantonale, Bellinzona, Switzerland., Aeschbacher S; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland., Ehret G; Division of Cardiology, Department of Medical Specialities, University Hospital Geneva, Geneva, Switzerland., Eken C; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland., Monsch A; Memory Clinic, Universitäre Altersmedizin, Felix Platter Spital Basel, University of Basel, Basel, Switzerland., Roten L; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Schwenkglenks M; Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zürich, Switzerland.; Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland., Springer A; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland., Sticherling C; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland., Reichlin T; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Zuern CS; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland., Meyre PB; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland., Blum S; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland., Sinnecker T; Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland.; Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, Univesity of Basel, Basel, Switzerland., Würfel J; Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, Univesity of Basel, Basel, Switzerland., Bonati LH; Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland., Conen D; Population Health Research Institute, McMaster University, 237 Barton Street East, Hamilton, ON, Canada L8L 2X2., Osswald S; Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2022 Jun 06; Vol. 43 (22), pp. 2127-2135.
DOI:	10.1093/eurheartj/ehac020
Abstrakt:	Aims: We aimed to investigate the association of clinically overt and silent brain lesions with cognitive function in atrial fibrillation (AF) patients. Methods and Results: We enrolled 1227 AF patients in a prospective, multicentre cohort study (Swiss-AF). Patients underwent standardized brain magnetic resonance imaging (MRI) at baseline and after 2 years. We quantified new small non-cortical infarcts (SNCIs) and large non-cortical or cortical infarcts (LNCCIs), white matter lesions (WML), and microbleeds (Mb). Clinically, silent infarcts were defined as new SNCI/LNCCI on follow-up MRI in patients without a clinical stroke or transient ischaemic attack (TIA) during follow-up. Cognition was assessed using validated tests. The mean age was 71 years, 26.1% were females, and 89.9% were anticoagulated. Twenty-eight patients (2.3%) experienced a stroke/TIA during 2 years of follow-up. Of the 68 (5.5%) patients with ≥1 SNCI/LNCCI, 60 (88.2%) were anticoagulated at baseline and 58 (85.3%) had a silent infarct. Patients with brain infarcts had a larger decline in cognition [median (interquartile range)] changes in Cognitive Construct score [-0.12 (-0.22; -0.07)] than patients without new brain infarcts [0.07 (-0.09; 0.25)]. New WML or Mb were not associated with cognitive decline. Conclusion: In a contemporary cohort of AF patients, 5.5% had a new brain infarct on MRI after 2 years. The majority of these infarcts was clinically silent and occurred in anticoagulated patients. Clinically, overt and silent brain infarcts had a similar impact on cognitive decline. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02105844, https://clinicaltrials.gov/ct2/show/NCT02105844. (© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu