| Autor: |
Kroman, Anne, Mahnkopf, Christian, K?hnlein, Peter, Mitlacher, Marcel, Kulandhaisamy, Suresh Kumar, Akoum, Nazem W |
| Zdroj: |
Circulation (Ovid); November 2019, Vol. 140 Issue: Supplement 1 pA11540-A11540, 1p |
| Abstrakt: |
Introduction:Atrial fibrillation (AF) is often implicated in Embolic Stroke of Unknown Source (ESUS). Atrial fibrosis may be an underlying mechanism for both AF and ESUS.Hypothesis:To compare atrial fibrosis across 4 different groups of patients: healthy controls, ESUS, AF without stroke and AF with stroke.Methods:We used late-gadolinium enhancement MRI (LGE-MRI) to compare left atrial fibrosis in 10 healthy controls, 35 patients with ESUS, 89 patients with AF and stroke, and 90 AF patients without stroke. Left atrial (LA) volume index, surface area and percent atrial wall fibrosis were compared between the groups.Results:The mean age was 65?14 years and 52% were female. ESUS patients had significantly more LA fibrosis than healthy controls (16.8% ? 5.2 vs 10.6% ? 5.7; p=0.026), and similar fibrosis to that of AF patients with stroke (18.3% ? 11.4; p=0.66) and AF patients without stroke (13.7?8.0; p=0.24). LA volume index (ESUS 38 ? 13; Control 35 ? 13; AF 63 ? 51 ml/m2) and area (ESUS 120 ? 28; Control 109 ? 30; AF 129 ? 41cm2) were not significantly different. Figure 1 depicts medians and IQR of LA fibrosis compared using Wilcoxon rank-sum tests.Conclusion:Patients with ESUS exhibit significantly more atrial fibrosis than control subjects, and similar to that seen in AF patients, supporting the hypothesis that atrial fibrosis is in the common causal pathway of cardioembolic stroke independent of AF. Prospective studies are needed to assess the role of anticoagulation in primary and secondary stroke prevention in patients with a high burden of atrial fibrosis. |
| Databáze: |
Supplemental Index |
| Externí odkaz: |
|
