Тhe aim – to evaluate association between silent cerebral infarctions (SCI), arterial hypertension and atrial fibrillation (AF) in patients without prior stroke.
Material and methods. We examined 157 patients without history of prior stroke: 124 with non-valvular AF and 33 patients with SR without history of AF. Clinical examination, laboratory tests, transesophageal, transthoracic echocardiography and brain multislice computed tomography were performed in all patients.
Results. SCIs were detected in 30.6 % (n=48) of patients: in 33.1 % (n=41) of patients with AF and in 21.2 % (n=7) of patients with SR, Р=0,2. SCI ≥ 15 mm were detected only in AF group in 8.1 % (n=10) of cases. Superficial and basal SCIs were detected both in groups of AF and SR (10.5 vs 9.1 %, Р=0.8 and 22.6 vs 21.2 %, Р=0.9, correspondingly), but superficial SCIs in AF group were significantly larger (20.0±13.6 vs. 4.8±0.3 mm, Р=0.01). The results of multivariate analysis showed that AF and arterial hypertension with office systolic blood pressure ≥ 160 mm Hg were independent predictors of SCI (OR 3,3; 95.% СІ 1.2 – 9.9; Р=0.03 and OR 3.5; 95 % СІ 1.1–10.0; Р=0.02). Low left atrial appendage velocity < 30 cm/s was independently associated with both SCI ≥ 15 mm (P=0.02) and superficial SCI (P=0.02) in patients with AF. Conclusion. AF and office SBP ≥ 160 mm Hg predicted SCI independent from age, gender, diabetes, low LV ejection fraction < 40 %, and creatinine clearance < 90 ml/min.