Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy

Knecht, Stefan; Oelschläger, Christian; Duning, Thomas; Lohmann, Hubertus; Albers, Johannes; Stehling, Christoph; Heindel, Walter; Breithardt, Günter; Berger, Klaus; Ringelstein, E. Bernd; Kirchhof, Paulus; Wersching, Heike

doi:10.1093/eurheartj/ehn341

Cited by 303 publications

(217 citation statements)

References 48 publications

Supporting

Mentioning

173

Contrasting

Unclassified

Order By: Relevance

“…For some evidences, an atrial fibrillation was relevant to cognitive impairment and hippocampal atrophy with no symptomatic stroke or silent infarction. 34,35 The previous studies 26,30,31,[36][37][38][39] and the results of our study have shown that atrial fibrillation was associated with an increased risk of poststroke dementia. Moreover, the result of this study found that stroke patients with atrial fibrillation risk of dementia were 1.68 times compared with stroke patients without atrial fibrillation statistically significant.…”

Section: Discussionmentioning

confidence: 50%

Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

This study aimed to evaluate the risk factors for prognostic of post-stroke dementia (PSD). A systematic review included case-control and/or cohort studies, we searched both published and unpublished literatures between 2000 to July 31, 2016. Two authors independently screened and selected research articles. If another one disagreed, the third author would be just along with his/her professionally. Moreover, Critical appraisal was measured by the quality (GRADE). Data collection was in the data extraction form. The Rev-Man 5.3 was used to estimate pooled data. The fixed-effect model will be used when the heterogeneity I² <50%, whereas the random-effects model will be used when the heterogeneity I²>50%. Result eight publications were pooled for measuring an association between risk factors and PSD by meta-analysis. There were 6 strongly PSD risk factors. The pooled relative ratio (RR) of atrial fibrillation was 1.68, previous stroke 1.59, myocardial infarction 1.40, hypertension 1.36, diabetes mellitus 1.25 and previous transient ischemic attack 1.25 respectively. Un-pooled data from 13 publications reported that the risk factors for dementia in stroke patients were i) demographic factors, ii) vascular risk factors, iii) stroke factors, iv) stroke complications, and v) abnormalities on brain imaging. Strongly risk factors associated with increasing PSD risk were atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes mellitus, and previous transient ischemic attack. Further studies, strongly risk factors need to investigate and develop the risk score for the prediction of dementia in stroke patients.

show abstract

Section: Discussionmentioning

confidence: 50%

Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Although the clinical relevance of these DWI lesions remains uncertain, they may cause decline in cognitive function as suggested by previous reports on silent cerebral lesions involving patients other than the typical TAVR patients [11,12,22]. For instance, the population-based Rotterdam Scan Study showed that elderly people with silent brain infarcts have an increased risk of dementia and a steeper decline in cognitive function than those without such lesions [11,12,22]. Therefore, based on these previous reports, the high frequency of ischemic lesions on post-TAVR cerebral imaging calls for procedural and technical developments to reduce the risk of peri-procedural embolization.…”

Section: Discussionmentioning

confidence: 89%

“…Although the consequences of silent ischemic brain lesions are still uncertain, in some studies they have been associated with cognitive decline and an increased risk of dementia and depression [11][12][13]. Furthermore, they have been shown to indicate an increased risk of subsequent stroke in patients with previous minor stroke and atrial fibrillation [13].…”

Section: Introductionmentioning

confidence: 99%

Silent ischemic brain lesions after transcatheter aortic valve replacement: lesion distribution and predictors

et al. 2015

View full text Add to dashboard Cite

Aims Silent ischemic brain lesions and ischemic stroke are known complications of transcatheter aortic valve replacement (TAVR). We aimed to investigate the occurrence and distribution of TAVR-related silent ischemic brain lesions using diffusion-weighted magnetic resonance imaging (DWI). Methods Consecutive patients with severe aortic valve stenosis treated with TAVR underwent cerebral DWI within 5 days after the index procedure. DWI scans were analyzed for the occurrence and distribution of new ischemic lesions post-TAVR. Results Forty-two patients were enrolled in this study. After TAVR, a total of 276 new cerebral ischemic lesions were detected in 38 (90 %) patients, with a median of 4.5 (interquartile range 2.0-7.0) lesions per patient. A total of 129 (47 %) lesions were detected in the cortical regions, 97 (35 %) in the subcortical regions, and 50 (18 %) in the cerebellum or brainstem. The median lesion volume was 20.2 ll (10.0, 42.7) and the total ischemic lesion volume was 132.3 ll (42.8, 336.9). The new ischemic brain lesions were clinically silent in 37 (97 %) patients; the other patient had a transient ischemic attack. Age (B = 0.528, p = 0.015), hyperlipidaemia (B = 5.809, p = 0.028) and post-dilatation of the implanted prosthesis (B = 7.196, p = 0.029) were independently associated with the number of post-TAVR cerebral DWI lesions. In addition, peak transaortic gradient was independently associated with post-procedural total infarct volume. Conclusion Clinically silent cerebral infarcts occurred in 90 % of patients following TAVR, most of which were small (\20 ll) and located in the cortical regions of the cerebral hemispheres. An independent association was found between age, hyperlipidaemia and balloon postdilatation and the number of post-TAVR ischemic brain lesions. Only peak transaortic gradient was independently associated with post-procedural total infarct volume.

show abstract

“…U pacjentów z AF często stwierdza się zmiany w istocie białej mózgu, zaburzenia czynności poznawczych [28][29][30], pogorszenie jakości życia [31,32] oraz obniżony nastrój [33], a każdego roku jest hospitalizowanych 10-40% pacjentów z AF [23,34,35]. Bezpośrednie koszty AF stanowią już w przybliżeniu 1% wszystkich wydatków na opiekę zdrowotną w Wielkiej Brytanii, a w Stanach Zjednoczonych w 2008 roku wyniosły 6-26 mld dolarów [36,37], co wynika z powikłań związanych z AF (np.…”

Section: Zgonunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

View full text Add to dashboard Cite

Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy

Abstract: Even in the absence of manifest stroke, AF is a risk factor for cognitive impairment and hippocampal atrophy. Therefore, cognition and measures of structural brain integrity should be considered in the evaluation of novel treatments for AF.

Cited by 303 publications

References 48 publications

Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

Silent ischemic brain lesions after transcatheter aortic valve replacement: lesion distribution and predictors

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Contact Info

Product

Resources

About