MRI-detected brain lesions in AF patients without further stroke risk factors undergoing ablation - a retrospective analysis of prospective studies
| Autor: | Herm, Juliane, Schurig, Johannes, Martinek, Martin R., Höltgen, Reinhard, Schirdewan, Alexander, Kirchhof, Paulus, Wieczorek, Marcus, Pürerfellner, Helmut, Heuschmann, Peter U., Fiebach, Jochen B., Haeusler, Karl Georg |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
lcsh:Diseases of the circulatory (Cardiovascular) system Time Factors Middle Aged Brain Ischemia Clinically silent stroke - atrial fibrillation - magnetic resonance imaging - cerebral microbleeds Stroke Peripheral Arterial Disease Diffusion Magnetic Resonance Imaging Sex Factors Treatment Outcome lcsh:RC666-701 Predictive Value of Tests Risk Factors Asymptomatic Diseases Atrial Fibrillation Catheter Ablation Prevalence Humans Female ddc:610 Research Article Aged Retrospective Studies |
| Zdroj: | BMC Cardiovascular Disorders BMC Cardiovascular Disorders, Vol 19, Iss 1, Pp 1-8 (2019) |
| DOI: | 10.1186/s12872-019-1035-1 |
| Popis: | Background Atrial fibrillation (AF) without other stroke risk factors is assumed to have a low annual stroke risk comparable to patients without AF. Therefore, current clinical guidelines do not recommend oral anticoagulation for stroke prevention of AF in patients without stroke risk factors. We analyzed brain magnetic resonance imaging (MRI) imaging to estimate the rate of clinically inapparent (“silent”) ischemic brain lesions in these patients. Methods We pooled individual patient-level data from three prospective studies comprising stroke-free patients with symptomatic AF. All study patients underwent brain MRI within 24–48 h before planned left atrial catheter ablation. MRIs were analyzed by a neuroradiologist blinded to clinical data. Results In total, 175 patients (median age 60 (IQR 54–67) years, 32% female, median CHA2DS2-VASc = 1 (IQR 0–2), 33% persistent AF) were included. In AF patients without or with at least one stroke risk factor, at least one silent ischemic brain lesion was observed in 4 (8%) out of 48 and 10 (8%) out of 127 patients, respectively (p > 0.99). Presence of silent ischemic brain lesions was related to age (p = 0.03) but not to AF pattern (p = 0.77). At least one cerebral microbleed was detected in 5 (13%) out of 30 AF patients without stroke risk factors and 25 (25%) out of 108 AF patients with stroke risk factors (p = 0.2). Presence of cerebral microbleeds was related to male sex (p = 0.04) or peripheral artery occlusive disease (p = 0.03). Conclusion In patients with symptomatic AF scheduled for ablation, brain MRI detected silent ischemic brain lesions in approximately one in 12 patients, and microbleeds in one in 5 patients. The prevalence of silent ischemic brain lesions did not differ in AF patients with or without further stroke risk factors. Electronic supplementary material The online version of this article (10.1186/s12872-019-1035-1) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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