A.O. Borodai, S.V. Fedkiv, E.S. Borodai, T.M. Shapovalov, O.V. Bachinskii, O.S. Sychov. MRI-defined brain lesions in patients with non-valvular atrial fibrillation

The aim – to evaluate MRI-defined brain lesions in patients with atrial fibrillation (AF) and sinus rhythm.

Material and methods. In a prospective cross sectional study we examined 88 patients, among them 39 (44.3 %) with atrial fibrillation (AF) and others with sinus rhythm without previous history of AF, by MRI. Arterial hypertension was detected in 89.7 % of patients with AF and in 98 % of patients with sinus rhythm.

Results. The prevalence of silent cerebral infarctions ≥ 15 mm was higher in patients with AF than in sinus rhythm (23.1 vs 6.1 %, Р=0.02). In univariate analysis periventricular leukoaraiosis (Р<0.0001), white matter hyperintensity (Р=0.006), heart failure NYHA class (Р=0.0001), CHA2DS2-VASc score (Р=0.006), atrial fibrillation (Р=0.002) and history of myocardial infarction (Р=0.03) were associated with cortical-subcortical cerebral infarctions ≥ 15 mm. Conclusions. White matter hyperintensity including leukoaraiosis was a main MRI-defined white matter lesion. Prevalence of cerebral infarctions was higher in patients with AF. Lesions in patients with AF were predominantly cortical and had a large ≥ 15 mm diameter. Periventricular leukoaraiosis was associated with overt stroke and silent cerebral infarctions with high degree of accuracy and according to current concepts should be considered a risk factor of the overt stroke.

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