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

17 Scopus citations


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
Issue number4
StatePublished - Apr 1 2019

Bibliographical note

Funding Information:
The ARIC study (Atherosclerosis Risk in Communities) has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under contract numbers HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, and HHSN268201700004I.

Funding Information:
L.Y. Chen is also supported by the National Heart, Lung, and Blood Institute grants R01 HL141288 and R01 HL126637. Dr Alonso is also supported by American Heart Association grant 16EIA26410001. The other authors report no conflicts.

Publisher Copyright:
© 2019 American Heart Association, Inc.


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


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