Association between advanced interatrial block and small vessel diseases in the brain

Wang, Zhaolu; Qin, Huiyuan; Chen, Guilin; Dai, Yan; Cai, Yingyuan; Cheng, Xi; Qian, Yun; Chu, Ming; Lu, Xiaowei

doi:10.21037/qims.2020.02.02

Cited by 4 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is a strong association between silent strokes and age, hypertension, carotid stenosis, chronic kidney disease and metabolic syndrome. Some studies have already reported an association of silent strokes with AF, heart failure, coronary artery disease and even with advanced interatrial block (17,18).…”

mentioning

confidence: 99%

Silent strokes after thoracoscopic epicardial ablation and catheter ablation for atrial fibrillation: not all lesions are permanent on follow-up magnetic resonance imaging

Malíková

Kremeňová

Budera

et al. 2021

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: Invasive treatments for atrial fibrillation (AF) pose a risk of ischemic stroke due to periprocedural brain embolization, which may be manifest or silent. The primary aim of our study was to compare the rate of silent strokes after percutaneous catheter-based and thoracoscopic epicardial ablation for AF. The secondary aim was to evaluate the development of silent strokes over time.Methods: We included 39 subjects (aged 64.1±8.9 years) treated for persistent symptomatic AF with thoracoscopic ablation and 30 subjects (aged 64.1±10.5 years) treated for paroxysmal or persistent symptomatic AF with catheter ablation. Subjects underwent brain MRI before and early after the ablation, moreover, the surgical group underwent late MRI 6 months after therapy. On early MRI, the presence of silent strokes and their number and size were evaluated. On late MRI, transformation of previously-detected acute ischemic lesions into chronic infarction or their reversibility were assessed.Results: Initially, different chronic ischemic findings were found in 64% of patients from the surgical group and in 70% from catheter group. Early MRI results: acute ischemic lesions were detected in 2 (6.7%) subjects (overall 3 lesions sized <5 mm) in the catheter group and in 17 (43.6%) subjects in surgical group.Most subjects in the surgical group showed multiple lesions (88%); 195 lesions were detected, a median 6 (IQR 8) lesions per case. Eighty-two percent of lesions were <5 mm, 12% 5-10 mm, 5% 10-30 mm, and 2% were large territorial ischemia. Only 1 case was symptomatic, the rest were silent strokes. On late MRI, 53.5% of all acute lesions were reversible. Lesions <5 mm were reversible in 63.1% of cases, lesions 5-10 mm were reversible in 21.7% and all lesions larger than 10 mm persisted. In 29.4% of patients all acute ischemic lesions were fully reversible.Conclusions: Periprocedural silent strokes were significantly more common after thoracoscopic epicardial ablation compared to catheter ablation considering both the number of affected patients and number of lesions. The majority of acute ischemic brain lesions were small, up to 5 mm in diameter, roughly half of which were reversible. Reversibility of acute ischemic lesions decreased with size. However, in 29.4% of affected patients, all lesions were fully reversible.

show abstract

mentioning

confidence: 99%

Silent strokes after thoracoscopic epicardial ablation and catheter ablation for atrial fibrillation: not all lesions are permanent on follow-up magnetic resonance imaging

Malíková

Kremeňová

Budera

et al. 2021

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…We collected data on basic demographic (age and gender) and vascular risk factors. Hypertension, diabetes mellitus (DM), and hyperlipidemia were defined according to our previous criteria (27). Smoking and alcohol intake were dichotomized as ever or never smoked and ever or never drank alcohol.…”

Section: Demography and Vascular Risk Factorsmentioning

confidence: 99%

“…Brain MRI (3.0 Tesla, TIM Trio; Siemens, Erlangen, Germany) was performed to detect SVD. We rated WMH, lacunes, and EPVS according to our previously published criteria (27). All ratings were performed blind to patients' clinical data.…”

Section: Neuroimaging Examinations Of Svdmentioning

confidence: 99%

See 1 more Smart Citation

Right-to-left shunts in unexplained syncope: an age- and sex-matched case-control study

Liu¹,

Chen²,

Gong³

et al. 2022

Quant Imaging Med Surg

Self Cite

View full text Add to dashboard Cite

Background: Syncope is common, but there is no clear cause for half of the patients diagnosed with syncope. Although suspected, there is limited evidence that right-to-left shunt (RLS) is related to syncope.This matched case-control study investigated the association between RLS (exposure) and unexplained syncope (outcome).Methods: Consecutive unexplained syncope cases, together with age-and gender-matched controls who did not have syncope were recruited from 2009 to 2010 in the first affiliated hospital of Nanjing Medical University. A transcranial Doppler ultrasonography bubble test was applied for the ascertainment of RLS.The degree of RLS was categorized into grades 0 to 4 according to the number of microemboli, which were no shunt, <10 microbubbles (MB), 11-25 MB, >25 MB single spots pattern, and MB in a shower/curtain pattern, respectively. Cerebral small vessel diseases (SVD), including white matter hyperintensity, lacunes, and enlarged perivascular spaces, were rated on Magnetic resonance imaging. Conditional logistic regression was used to examine the association between RLS and unexplained syncope.Results: A total of 52 cases and 52 age-and gender-matched controls were recruited. Among the 52 cases, 4 patients had a history of migraine. Among the 104 participants, 68 had no RLS; 13, 4, 7, and 12 presented with <10, 11-25, >25, and shower/curtain MB, respectively. The incidence of any RLS (Grade 1-4) was 48.1% (25/52) in cases and 21.2% (11/52) in controls (P=0.004). Conditional logistic regression showed an association between RLS and unexplained syncope [odds ratio (OR) =1.988; 95% confidence interval (CI):1.233 to 3.205; P=0.005] adjusting for SVD burden. Further analysis revealed a large OR between severe RLS (Grade 3-4) and unexplained syncope (OR =8.699; P=0.006). Furthermore, SVD burden was shown to be associated with syncope.Conclusions: This matched case-control study showed a significant association between RLS and unexplained syncope, independent of cerebral SVD. Prospective studies are needed to confirm the causal relationship.

show abstract

“…Recientemente, Wang et al (29) investigaron la relación entre BIA-A y el grado de enfermedad cerebral silente de pequeños vasos (SVD) en la resonancia magnética, en (29) .…”

Section: Relación Entre Síndrome De Bayés Y Lesiones Isquémicas Cerebrales Silentesunclassified

Síndrome de Bayés, accidente cerebrovascular y demencia

Iomini

Martínez‐Sellés

Elosúa³

et al. 2021

Arch Peru Cardiol Cir Cardiovasc

View full text Add to dashboard Cite

El síndrome de Bayés es una entidad clínica que se define como la asociación entre la presencia de bloqueo interauricular avanzado (BIA-A), y el desarrollo de taquiarritmias supraventriculares (TSV), siendo la fibrilación auricular (FA), la más frecuente. Esta asociación salió a la luz con los estudios del Prof. Antoni Bayés de Luna en los años ‘80. Estudios realizados posteriormente por otros grupos encontraron una fuerte asociación entre este síndrome y la ocurrencia de fenómenos tromboembólicos, siendo el accidente cerebrovascular (ACV) el más grave. Del mismo modo, se documentó una asociación con deterioro cognitivo y demencia. Esto generó la pregunta acerca de si la terapia de anticoagulación previa a la documentación de FA podría prevenir la ocurrencia de tromboembolismos asociados al BIA-A y de esta manera preservar el estado cognitivo. Esta pregunta permanece, aún hoy, sin respuesta definitiva. Existen estudios en diferentes estadios de su desarrollo cuyo objetivo es comparar la efectividad de la anticoagulación en pacientes con BIA-A y sin FA documentada. Los resultados de los mismos permitirán establecer la efectividad de esta opción terapéutica temprana y, de manera conclusiva, definir si, para decidir anticoagular un paciente, la FA tiene que ser previamente documentada o no.

show abstract

Association between advanced interatrial block and small vessel diseases in the brain

Cited by 4 publications

References 29 publications

Silent strokes after thoracoscopic epicardial ablation and catheter ablation for atrial fibrillation: not all lesions are permanent on follow-up magnetic resonance imaging

Silent strokes after thoracoscopic epicardial ablation and catheter ablation for atrial fibrillation: not all lesions are permanent on follow-up magnetic resonance imaging

Right-to-left shunts in unexplained syncope: an age- and sex-matched case-control study

Síndrome de Bayés, accidente cerebrovascular y demencia

Contact Info

Product

Resources

About