TY - JOUR
T1 - Atrial Fibrillation and Brain Magnetic Resonance Imaging Abnormalities
T2 - The ARIC Study
AU - Berman, Jeremy P.
AU - Norby, Faye
AU - Mosley, Thomas
AU - Soliman, Elsayed Z.
AU - Gottesman, Rebecca F.
AU - Lutsey, Pamela L
AU - Alonso, Alvaro
AU - Chen, Lin Y.
N1 - Publisher Copyright:
© 2019 American Heart Association, Inc.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - 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.
AB - 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.
KW - atrial fibrillation
KW - cognitive dysfunction
KW - dementia
KW - magnetic resonance imaging
KW - research
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UR - http://www.scopus.com/inward/citedby.url?scp=85063711994&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.118.024143
DO - 10.1161/STROKEAHA.118.024143
M3 - Article
C2 - 30908155
AN - SCOPUS:85063711994
SN - 0039-2499
VL - 50
SP - 783
EP - 788
JO - Stroke
JF - Stroke
IS - 4
ER -