Silent brain infarcts impact on cognitive function in atrial fibrillation

被引：71

作者：

Kuehne, Michael ^{[1
,2
]}

Krisai, Philipp ^{[1
,2
]}

Coslovsky, Michael ^{[2
,3
]}

Rodondi, Nicolas ^{[4
,5
]}

Mueller, Andreas ^{[6
]}

Beer, Jurg H. ^{[7
]}

Ammann, Peter ^{[8
]}

Auricchio, Angelo ^{[9
]}

Moschovitis, Giorgio ^{[10
]}

Hayoz, Daniel ^{[11
]}

Kobza, Richard ^{[12
]}

Shah, Dipen ^{[13
]}

Stephan, Frank Peter ^{[14
]}

Schlaepfer, Juerg ^{[15
]}

Di Valentino, Marcello ^{[16
]}

Aeschbacher, Stefanie ^{[1
,2
]}

Ehret, Georg ^{[13
]}

Eken, Ceylan ^{[1
,2
]}

Monsch, Andreas ^{[17
]}

Roten, Laurent ^{[18
]}

Schwenkglenks, Matthias ^{[19
,20
]}

Springer, Anne ^{[1
,2
]}

Sticherling, Christian ^{[1
,2
]}

Reichlin, Tobias ^{[18
]}

Zuern, Christine S. ^{[1
,2
]}

Meyre, Pascal B. ^{[1
,2
]}

Blum, Steffen ^{[1
,2
]}

Sinnecker, Tim ^{[21
,22
,23
,24
]}

Wuerfel, Jens ^{[23
,24
]}

Bonati, Leo H. ^{[21
,22
]}

Conen, David ^{[25
]}

Osswald, Stefan ^{[1
,2
]}

机构：

[1] Univ Basel, Univ Hosp Basel, Dept Med, Cardiol Electrophysiol Div, Petersgraben 4, CH-4031 Basel, Switzerland

[2] Univ Basel, Univ Hosp Basel, Cardiovasc Res Inst Basel, Basel, Switzerland

[3] Univ Hosp Basel, Dept Clin Res, Clin Trial Unit Basel, Basel, Switzerland

[4] Univ Bern, Inst Primary Hlth Care BIHAM, Bern, Switzerland

[5] Univ Bern, Bern Univ Hosp, Dept Gen Internal Med, Inselspital, Bern, Switzerland

[6] Triemli Hosp Zurich, Dept Cardiol, Zurich, Switzerland

[7] Univ Hosp Zurich, Conatonal Hosp Baden & Mol Cardiol, Dept Med, Zurich, Switzerland

[8] Kantonsspital St Gallen, Dept Cardiol, St Gallen, Switzerland

[9] Fdn Cardioctr Ticino, Div Cardiol, Lugano, Switzerland

[10] Ente Osped Cantonale, Div Cardiol, Osped Reg Lugano, Lugano, Switzerland

[11] HRF Hop Cantonal Fribourg, Dept Internal Med, Fribourg, Switzerland

[12] Luzerner Kantonsspital, Dept Cardiol, Luzern, Switzerland

[13] Univ Hosp Geneva, Dept Med Special, Div Cardiol, Geneva, Switzerland

[14] Burgerspital, Dept Cardiol, Solothurn, Switzerland

[15] CHU Vaudois, Dept Cardiol, Lausanne, Switzerland

[16] Ente Osped Cantonale, Div Cardiol, Osped San Giovanni, Bellinzona, Switzerland

[17] Univ Basel, Univ Altersmed, Felix Platter Spital Basel, Memory Clin, Basel, Switzerland

[18] Univ Bern, Bern Univ Hosp, Dept Cardiol, Inselspital, Bern, Switzerland

[19] Univ Zurich, Epidemiol Biostat & Prevent Inst, Zurich, Switzerland

[20] Univ Basel, Inst Pharmaceut Med ECPM, Basel, Switzerland

[21] Univ Basel, Univ Hosp Basel, Dept Neurol, Basel, Switzerland

[22] Univ Basel, Univ Hosp Basel, Stroke Ctr, Basel, Switzerland

[23] Univ Basel, Med Image Anal Ctr MIAC, Basel, Switzerland

[24] Univ Basel, Dept Biomed Engn, Basel, Switzerland

[25] McMaster Univ, Populat Hlth Res Inst, 237 Barton St East, Hamilton, ON L8L 2X2, Canada

来源：

EUROPEAN HEART JOURNAL | 2022年 / 43卷 / 22期

基金：

瑞士国家科学基金会;

关键词：

Atrial fibrillation; Cognitive function; Brain infarction; Oral anticoagulation; Magnetic resonance imaging; NORMATIVE DATA; WARFARIN; RISK; COUNTRIES; STROKE; TRAIL; DEATH; MOCA;

D O I：

10.1093/eurheartj/ehac020

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims We aimed to investigate the association of clinically overt and silent brain lesions with cognitive function in atrial fibrillation (AF) patients. Methods and results We enrolled 1227 AF patients in a prospective, multicentre cohort study (Swiss-AF). Patients underwent standardized brain magnetic resonance imaging (MRI) at baseline and after 2 years. We quantified new small non-cortical infarcts (SNCIs) and large non-cortical or cortical infarcts (LNCCIs), white matter lesions (WML), and microbleeds (Mb). Clinically, silent infarcts were defined as new SNCI/LNCCI on follow-up MRI in patients without a clinical stroke or transient ischaemic attack (TIA) during follow-up. Cognition was assessed using validated tests. The mean age was 71 years, 26.1% were females, and 89.9% were anticoagulated. Twenty-eight patients (2.3%) experienced a stroke/TIA during 2 years of follow-up. Of the 68 (5.5%) patients with >= 1 SNCI/LNCCI, 60 (88.2%) were anticoagulated at baseline and 58 (85.3%) had a silent infarct. Patients with brain infarcts had a larger decline in cognition [median (interquartile range)] changes in Cognitive Construct score [-0.12 (-0.22; -0.07)] than patients without new brain infarcts [0.07 (-0.09; 0.25)]. New WML or Mb were not associated with cognitive decline. Conclusion In a contemporary cohort of AF patients, 5.5% had a new brain infarct on MRI after 2 years. The majority of these infarcts was clinically silent and occurred in anticoagulated patients. Clinically, overt and silent brain infarcts had a similar impact on cognitive decline.

引用

页码：2127 / 2135

页数：9

共 26 条

[1] Blood Pressure and Brain Lesions in Patients With Atrial Fibrillation [J].

Aeschbacher, Stefanie ;

Blum, Steffen ;

Meyre, Pascal B. ;

Coslovsky, Michael ;

Vischer, Annina S. ;

Sinnecker, Tim ;

Rodondi, Nicolas ;

Beer, Juerg H. ;

Moschovitis, Giorgio ;

Moutzouri, Elisavet ;

Hunkeler, Christof ;

Burkard, Thilo ;

Eken, Ceylan ;

Roten, Laurent ;

Zuern, Christine S. ;

Sticherling, Christian ;

Wuerfel, Jens ;

Bonati, Leo H. ;

Conen, David ;

Osswald, Stefan ;

Kuehne, Michael .

HYPERTENSION, 2021, 77 (02) :662-671

[2]

Arbuthnott K, 2000, J CLIN EXP NEUROPSYC, V22, P518, DOI 10.1076/1380-3395(200008)22:4

[3]

1-0

[4]

FT518

[5]

Borland E, 2017, J ALZHEIMERS DIS, V59, P893, DOI [10.3233/JAD-170203, 10.3233/jad-170203]

[6] Administration and interpretation of the trail making test [J].

Bowie, Christopher R. ;

Harvey, Philip D. .

NATURE PROTOCOLS, 2006, 1 (05) :2277-2281

[7]

Camm AJ, 2010, EUR HEART J, V31, P2369, DOI [10.1093/eurheartj/ehq278, 10.1093/europace/euq350]

[8] Atrial Fibrillation and Cognitive Decline-The Role of Subclinical Cerebral Infarcts The Atherosclerosis Risk in Communities Study [J].

Chen, Lin Y. ;

Lopez, Faye L. ;

Gottesman, Rebecca F. ;

Huxley, Rachel R. ;

Agarwal, Sunil K. ;

Loehr, Laura ;

Mosley, Thomas ;

Alonso, Alvaro .

STROKE, 2014, 45 (09) :2568-+

[9] Constructing inverse probability weights for marginal structural models [J].

Cole, Stephen R. ;

Hernan, Miguel A. .

AMERICAN JOURNAL OF EPIDEMIOLOGY, 2008, 168 (06) :656-664

[10] Relationships of Overt and Silent Brain Lesions With Cognitive Function in Patients With Atrial Fibrillation [J].

Conen, David ;

Rodondi, Nicolas ;

Mueller, Andreas ;

Beer, Juerg H. ;

Ammann, Peter ;

Moschovitis, Giorgio ;

Auricchio, Angelo ;

Hayoz, Daniel ;

Kobza, Richard ;

Shah, Dipen ;

Novak, Jan ;

Schlapfer, Jurg ;

Di Valentino, Marcello ;

Aeschbacher, Stefanie ;

Blum, Steffen ;

Meyre, Pascal ;

Sticherling, Christian ;

Bonati, Leo H. ;

Ehret, Georg ;

Moutzouri, Elisavet ;

Fischer, Urs ;

Monsch, Andreas U. ;

Stippich, Christoph ;

Wuerfel, Jens ;

Sinnecker, Tim ;

Coslovsky, Michael ;

Schwenkglenks, Matthias ;

Kuhne, Michael ;

Osswald, Stefan .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2019, 73 (09) :989-999

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