O.S. Sychov, A.O. Borodai, S.V. Fedkiv, E.S. Borodai, A.Yu. Rybak, L.L. Vavilova.

The aim – to evaluate association between silent cerebral infarctions and death in patients with nonvalvular atrial fibrillation during two years follow-up.

Material and methods. In prospective longitudinal study with 25.3 months follow-up we examined 103 patients with nonvalvular atrial fibrillation without prior history of stroke. All patients underwent standard clinical examination, transthoracic echocardiography and multislice computed tomography. Transesophageal echocardiography was performed in 95 patients.

Results. Cortical-subcortical infarctions ≥ 15 mm were found in 10 (9.7 %) of patients and deep white matter or basal ganglia infarctions were found in 25 (24.3 %). Endpoint outcomes were registered in 10 (9.7 %) of patients: ischemic stroke – in 5 (4.85 %), death – in 3 (2.9 %), and thrombosis of peripheral arteries – in 2 (1.94 %) patients. The combined endpoint was associated with male gender (Р=0.03), functional class NYHA III–IV (Р=0.048), myocardial mass index ≥130 g/m2 (Р=0.009), left atrial volume index ≥ 48 ml/m2 (Р=0.008), spontaneous echo contrast in the left atrial appendage (LAA) 3–4+ (Р=0.04), and LV thrombus (Р=0.005). Left atrial appendage velocity ≤ 30 сm/s, was significantly associated with stroke (Р=0.03). Silent cerebral infarctions were not associated with cardio-vascular events.

Conclusions. Silent cerebral infarctions were not associated with thromboembolic events and/or death during two years follow-up. In multivariate logistic regression model LAA spontaneous echo contrast 3–4+ and left ventricular thrombus were independently associated with cardiovascular outcomes.

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