Swedish researchers found an association between atrial fibrillation (AF) and “a broad range of cerebrovascular pathologies[,]” including symptomatic stroke, large infarcts, lacunes, silent brain infarcts, larger white matter hyperintensities (but not in individuals without symptomatic stroke), and frontal-lobe cerebral microbleeds. The study was available online on September 14, 2021. 

“A total of 776 individuals were included and 65 (8.4%) had AF. AF was associated with symptomatic stroke (OR 4.5, 95% CI 2.1-9.5), and MRI findings of large infarcts (OR 5.0, 95% CI 1.5-15.9), lacunes (OR 2.7, 95% CI 1.2-5.6), and silent brain infarcts (OR 3.5; 95% CI 1.6-7.4). Among those with symptomatic stroke, individuals with AF had larger WMH volumes (0.0137 ml/total intracranial volume (TIV), 95% CI 0.0074-0.0252) compared to those without AF (0.0043 ml/TIV, 95% CI 0.0029-0.0064). There was no association between AF and WMH volumes among those without symptomatic stroke. In addition, AF was associated to (sic) CMBs in the frontal lobe,” wrote the team, led by Dr. Lina Rydén of the University of Gothenburg.

The team noted that it may be possible to use cerebrovascular MRI markers to personalize anticoagulant treatment in patients with AF, but that further research was needed. “Further research is needed to establish whether cerebrovascular MRI markers can be used as a complement to current treatment guidelines to further personalise (sic) anticoagulant treatment in AF patients and to further characterize the pathogenetic processes underlying the associations between AF and cerebrovascular diseases, as well as dementia.”

Sources:

Lina Rydén, Simona Sacuiu, Hanna Wetterberg, Jenna Najar, Xinxin Guo, Silke Kern, Anna Zettergren, Sara Shams, Joana B. Pereira, Lars-Olof Wahlund, Eric Westman, Ingmar Skoog. Atrial Fibrillation, Stroke, and Silent Cerebrovascular Disease: A Population-Based MRI Study. Neurology Sep 2021, 10.1212/WNL.0000000000012675; DOI: 10.1212/WNL.0000000000012675. Accessed October 14, 2021, at https://n.neurology.org/content/early/2021/09/14/WNL.0000000000012675.

Yee, Kate. Brain MRI shows link between atrial fibrillation and cognitive decline. AuntMinnie.com September 23, 2021, at https://www.auntminnie.com/index.aspx?sec=sup&sub=mri&pag=dis&ItemID=133545. Accessed October 14, 2021.