Atrial Fibrillation and Brain Magnetic Resonance Imaging Abnormalities: The ARIC Study

Jeremy P. Berman, Faye Norby, Thomas Mosley, Elsayed Z. Soliman, Rebecca F. Gottesman, Pamela L Lutsey, Alvaro Alonso, Lin Y. Chen

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Background and Purpose - Atrial fibrillation (AF) is associated with dementia independent of clinical stroke. The mechanisms underlying this association remain unclear. In a community-based cohort, the ARIC study (Atherosclerosis Risk in Communities), we evaluated (1) the longitudinal association of incident AF and (2) the cross-sectional association of prevalent AF with brain magnetic resonance imaging (MRI) abnormalities. Methods - The longitudinal analysis included 963 participants (mean age, 73±4.4 years; 62% women; 51% black) without prevalent stroke or AF who underwent a brain MRI in 1993 to 1995 and a second MRI in 2004 to 2006 (mean, 10.6±0.8 years). Outcomes included subclinical cerebral infarctions, sulcal size, ventricular size, and, for the cross-sectional analysis, white matter hyperintensity volume and total brain volume. Results - In the longitudinal analysis, 29 (3.0%) participants developed AF after the first brain MRI. Those who developed AF had higher odds of increase in subclinical cerebral infarctions (odds ratio [OR], 3.08; 95% CI, 1.39-6.83), worsening sulcal grade (OR, 3.56; 95% CI, 1.04-12.2), and worsening ventricular grade (OR, 9.34; 95% CI, 1.24-70.2). In cross-sectional analysis, of 969 participants, 35 (3.6%) had prevalent AF at the time of the 2004 to 2006 MRI scan. Those with AF had greater odds of higher sulcal (OR, 3.9; 95% CI, 1.7-9.1) and ventricular grade (OR, 2.4; 95% CI, 1.0-5.7) after multivariable adjustment and no difference in white matter hyperintensity or total brain volume. Conclusions - AF is independently associated with increase in subclinical cerebral infarction and worsening sulcal and ventricular grade - morphological changes associated with aging and dementia. More research is needed to define the mechanisms underlying AF-related neurodegeneration.

Original languageEnglish (US)
Pages (from-to)783-788
Number of pages6
JournalStroke
Volume50
Issue number4
DOIs
StatePublished - Apr 1 2019

Bibliographical note

Publisher Copyright:
© 2019 American Heart Association, Inc.

Keywords

  • atrial fibrillation
  • cognitive dysfunction
  • dementia
  • magnetic resonance imaging
  • research

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