Relationships of Overt and Silent Brain Lesions With Cognitive Function in Patients With Atrial Fibrillation

Conen, David; Rodondi, Nicolas; Müller, Antje; Beer, Jürg H.; Ammann, Peter; Moschovitis, Giorgio; Auricchio, Angelo; Hayoz, Daniel; Kobza, Richard; Shah, Dipen; Novák, Jan; Schläpfer, Jürg; Valentino, Marcello Di; 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; Kühne, Michael; Oßwald, Stefan; investigators, Swiss-AF study

doi:10.1016/j.jacc.2018.12.039

Cited by 172 publications

(158 citation statements)

References 26 publications

Supporting

Mentioning

151

Contrasting

Unclassified

Order By: Relevance

“…However, mechanism of AF associated cognitive impairment is more complex. MCI in AF patients are more likely to be cerebrovascular origin [20,21], with multiple brain lesions, including cerebral small vessel disease and ischemic cerebral lesions [22]. These lesions typically impair attention and executive function [23].…”

Section: Discussionmentioning

confidence: 99%

Validation of T-MoCA in the screening of mild cognitive impairment in Chinese patients with atrial fibrillation

Lai¹,

Jiang²,

Du³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Atrial fibrillation (AF) is associated with high risk of mild cognitive impairment (MCI) and dementia. However, feasible and simple instruments that facilitates regular assessment of cognitive status in AF patients remain underdeveloped. Methods: Cognitive function of 136 AF patients was first evaluated using T-MoCA. Cognitive function of 101 patients was then assessed through in-person interview by physicians who are blinded to telephone interview results, using both Clinical Dementia Rating (CDR) and Mini-Mental Status Evaluation (MMSE). Using CDR=0.5 as a reference standard, the ability of T-MoCA and MMSE to discriminate cognitive dysfunction, stratified by education level, was tested by receiver-operating curve (ROC) analysis. Net reclassification index was calculated for comparison between the performance of T-MoCA and MMSE. Results: Thirty-five MCI patients were identified as MCI using the criteria of CDR=0.5. The areas under the ROC curve of T-MoCA were 0.80 (0.71-0.89), 0.83 (0.71-0.95), and 0.85 (0.64-0.92) for all patients, patients with high educational level, and patients with low education level, respectively. The optimal threshold was achieved at 16/17 with a sensitivity of 85.7% and a specificity of 69.7% in overall patients, 15/16 with a sensitivity of 88.2% and a specificity of 64.5% in the low educational level patients, and 16/17 with a sensitivity of 77.8% and a specificity of 87.9% in the high educational level patients. Compared to the criterion MMSE≤27 and MMSE norms for the Chinese community elderly, stratified T-MoCA threshold improves correct classification by 23.7% (p=0.033) and 30.3% (p=0.020) respectively. Conclusion: T-MoCA is a feasible and effective method for MCI screening in patients with AF.

show abstract

Section: Discussionmentioning

confidence: 99%

Validation of T-MoCA in the screening of mild cognitive impairment in Chinese patients with atrial fibrillation

Lai¹,

Jiang²,

Du³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The CMR protocol included standard steady-state free-precession cine CMR, black-blood T2-weighted short tau inversion recovery images, T1-weighted spin-echo early gadolinium enhancement (EGE) CMR, and phase-sensitive inversion recovery late gadolinium enhancement (LGE) CMR as described previously [6]. A dose of 0.1 mmol/kg gadobenate dimeglumine contrast-medium was injected for the acquisition of EGE and another 0.1 mmol/kg for the acquisition of LGE images, as suggested by the Lake Louise criteria [22].…”

Section: Cmr Studymentioning

confidence: 99%

“…Current evidence also supports the notion that cardiac pathologies may set the stage for the development of pathologic alterations of the cerebral parenchyma. The prototypical example of this is atrial fibrillation (AF); in a recent study, more than 1/5 AF patients had cortical/non-cortical stroke or microbleeds and almost all AF patients had white matter hyperintensities (WMHs), despite being appropriately treated with anti-coagulation [6]. Importantly, neurologic deficits or cognitive dysfunction may not become apparent for considerable time intervals after the appearance of cerebral parenchymal lesions [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Combined Brain-Heart Magnetic Resonance Imaging in Autoimmune Rheumatic Disease Patients with Cardiac Symptoms: Hypothesis Generating Insights from a Cross-Sectional Study

Markousis‐Mavrogenis

Mitsikostas

Κουτσογεωργοπούλου

et al. 2020

JCM

View full text Add to dashboard Cite

Background: Autoimmune rheumatic diseases (ARDs) may affect both the heart and the brain. However, little is known about the interaction between these organs in ARD patients. We asked whether brain lesions are more frequent in ARD patients with cardiac symptoms compared with non-ARD patients with cardiovascular disease (CVD). Methods: 57 ARD patients with mean age of 48 ± 13 years presenting with shortness of breath, chest pain, and/or palpitations, and 30 age-matched disease-controls with non-autoimmune CVD, were evaluated using combined brain–heart magnetic resonance imaging (MRI) in a 1.5T system. Results: 52 (91%) ARD patients and 16 (53%) controls had white matter hyperintensities (p < 0.001) in at least one brain area (subcortical/deep/periventricular white matter, basal ganglia, pons, brainstem, or mesial temporal lobe). Only the frequency and number of subcortical and deep white matter lesions were significantly greater in ARD patients (p < 0.001 and 0.014, respectively). ARD vs. control status was the only independent predictor of having any brain lesion. Specifically for deep white matter lesions, each increase in ECV independently predicted a higher number of lesions [odds ratio (95% confidence interval): 1.16 (1.01–1.33), p = 0.031] in ordered logistic regression. Penalized logistic regression selected only ARD vs. control status as the most important feature for predicting whether brain lesions were present on brain MRI (odds ratio: 5.46, marginal false discovery rate = 0.011). Conclusions: Subclinical brain involvement was highly prevalent in this cohort of ARD patients and was mostly independent of the severity of cardiac involvement. However, further research is required to determine the clinical relevance of these findings.

show abstract

“…Необходимо отметить, что у значительной доли пациентов с ФП без анамнеза инсультов и транзиторных ишемических атак (ТИА) данные визуализации позволяли диагностировать ранее перенесенные бессимптомные инфаркты как малого (18 %), так и большого размера (15 %). Наличие крупного постинсультного поражения было ассоциировано с клинической выраженностью КД (24,7±3,3 балла против 25,8±2,9 балла по MoCA; p<0,001), а в многофакторном анализе размер очагов был наиболее значимым предиктором наличия КД [36].…”

Section: бессимптомные инфаркты головного мозгаunclassified

“…В популяционном когортном исследовании с участием 332 665 пациентов ( [58]. Было также отмечено, что пациенты с постоянной формой ФП имеют более выраженную КД, чем больные пароксизмальной и персистирующей ФП [36].…”

Section: оценка риска и профилактика кд при фпunclassified

Cognitive Dysfunction at the Background of Atrial Fibrillation: Clinical-Pathological Aspects, Diagnostics and Prevention, Issues of the Use of the Application of Anticoagulant Therapy

2019

View full text Add to dashboard Cite

Atrial fibrillation (AF) and cognitive dysfunction - common states with similar risk factors. Recently significant scientific epidemiological data has been received in favor of independence of effect of AF on possibility of development of cognitive dysfunction. In this review we present problems of prevalence, pathogenesis, and diagnostics of various variants of cognitive disorders at the background of AF, as well as methods of their prevention and tactics of anticoagulant therapy in the presence of cognitive disturbances.

show abstract

Relationships of Overt and Silent Brain Lesions With Cognitive Function in Patients With Atrial Fibrillation

Cited by 172 publications

References 26 publications

Validation of T-MoCA in the screening of mild cognitive impairment in Chinese patients with atrial fibrillation

Validation of T-MoCA in the screening of mild cognitive impairment in Chinese patients with atrial fibrillation

Combined Brain-Heart Magnetic Resonance Imaging in Autoimmune Rheumatic Disease Patients with Cardiac Symptoms: Hypothesis Generating Insights from a Cross-Sectional Study

Cognitive Dysfunction at the Background of Atrial Fibrillation: Clinical-Pathological Aspects, Diagnostics and Prevention, Issues of the Use of the Application of Anticoagulant Therapy

Contact Info

Product

Resources

About