Atrial cardiopathy is associated with cerebral microbleeds in ischemic stroke patients

Abstract

ObjectiveCerebral microbleeds (CMB) are small accumulations of hemosiderin associated with cerebrovascular risk factors, but whether they are associated with atrial cardiopathy is not known. The goal of this study is to determine, among ischemic stroke patients, the association between study-defined atrial cardiopathy and CMB presence, location, and number.MethodsIschemic stroke patients admitted to Johns Hopkins (2015–2019) with transthoracic echocardiography and electrocardiography were included. Cerebral microbleeds were defined as small, round hypo-intensities on T2* susceptibility weighted imaging or gradient recalled echo magnetic resonance imaging sequences. Atrial cardiopathy was defined as the presence of ≥1: left atrium diameter >4.0 cm (males) or >3.8 cm (females), PR interval >200 ms, or N-terminal pro-B-type natriuretic peptide >250 pg/ml. Binary/Ordinal logistic regression models were used to determine the association between atrial cardiopathy, and cerebral microbleed presence, location (lobar/deep), or number, each, adjusted for potential confounders.ResultsPatients (N = 120) were mean age 60 years (range 22–98), 46% female, 62% black, and 39% were on anti-thrombotic medication at time of admission. 39 (32%) participants had ≥1 cerebral microbleeds. Forty-six (38%) patients had atrial cardiopathy. Atrial cardiopathy was associated with higher odds of having cerebral microbleeds (OR 2.50, 95% CI 1.02–6.15). Atrial cardiopathy was associated with lobar cerebral microbleeds (OR 2.33, 95% CI 1.01–5.37) in univariate analysis but not with deep cerebral microbleeds (OR 0.45, 95% CI 0.13–1.54), with neither association significant after adjustment. There was no difference in risk of having 1 vs. no cerebral microbleeds (RRR 2.51, 95% CI 0.75–8.37) and >1 cerebral microbleed vs none (RRR 2.57, 95% CI 0.87–7.60) among those with atrial cardiopathy.ConclusionsAtrial cardiopathy is associated with the presence, but not burden, of cerebral microbleeds in ischemic stroke patients. We cautiously suggest that atrial cardiopathy, either directly or through shared vascular risk, may contribute to the presence of CMB.

Atrial Cardiomyopathy Predicts the Functional Outcome and Mortality in Stroke Patients

“…Patients with NCS with ACM had a significantly prospectively validating ACM's predictive value of ACM for long-term outcomes in patients with NCSs. We observed that the prevalence of ACM in our cohort was notably lower than what has been previously reported (22.2% vs. 38.3%) 19) , a difference that could be attributed to varying definitions and subtypes of stroke examined in different studies.…”

“…Smoking was defined as continuous smoking of at least one cigarette per day for at least six months. ACM was defined when any of the following conditions were satisfied: (1) NT-Pro BNP ＞250 pg/ ml 19) ; (2) PTFV1 ≥ 5,000μV•ms 20) .…”

The relationship between atrial cardiopathy biomarkers and prognosis of patients with acute ischemic stroke after endovascular treatment

“…This approach was chosen to address sparse data biases and possible separation for small sample size data in OR estimation [ 26 ]. All regression models were adjusted stepwise for potential confounders based on the literature [ 27 , 28 ]. We used SPSS version 26.0 (Chicago, IL) and R-4.3.1 for Windows (R Foundation for Statistical Computing, Vienna, Austria.…”

Analysis of the relationship between body habitus and frailty of community adults in Chongqing: a cross-sectional survey study

“…This situation can lead to unstable predictive outcomes and compromise the overall reliability of the model. When p > 0.05, the response curves of each variable at varying levels of categorical variables exhibit parallelism, which can be analyzed using an ordered logistic regression model (36,37). As a result, except for WHR and comorbidities analyzed using unordered logistic regression, all other independent variables can be analyzed using ordered logistic regression.…”