Zhaolu Wang1, Huiyuan Qin2, Guilin Chen3, Vincent C T Mok4, Yan Dai5, Yingyuan Cai6, Xi Cheng6, Yun Qian6, Ming Chu2,7, Xiaowei Lu6. 1. Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. 2. Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. 3. Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. 4. Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, the Chinese University of Hong Kong, Hong Kong, China. 5. The First School of Clinical Medicine, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. 6. Division of Neurology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. 7. Department of Cardiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, China.
Abstract
BACKGROUND: The latest evidence shows the association of atrial cardiopathy with embolic strokes of undetermined source. Advanced interatrial block (aIAB) is an electrophysiological mark of atrial cardiopathy. This study investigated the relationship between aIAB and the burden of silent cerebral small vessel diseases (SVD) on magnetic resonance imaging in the absence of atrial fibrillation (AF) and atrial flutter. METHODS: This cross-sectional study included 499 patients with normal left ventricular ejection fraction (LVEF), who were free of AF, atrial flutter, stroke, and acute coronary syndrome in our hospital. aIAB was ascertained by digital electrocardiograms. Left atrial diameter, LVEF, and left ventricular posterior wall thickness (LVPWT) were measured on echocardiograms. Based on the presence of 4 manifestations of SVD, including white matter hyperintensity (WMH), lacunes, microbleeds, and enlarged perivascular spaces (EPVS) on magnetic resonance imaging, an ordinal SVD score (range, 0-4) was devised to reflect the total burden of cerebral SVD. The ordinal regression model was used to explore the association of aIAB with SVD burden after adjusting for confounding factors. RESULTS: The mean age was 67.7 years, and 327 (65.5%) were male. A total of 23 (4.6%) patients had aIAB. The number of patients with cerebral SVD scores of 0, 1, 2, 3, and 4 was 92 (18.4%), 122 (24.4%), 190 (38.1%), 83 (16.6%), and 12 (2.4%), respectively. After adjusting for age, sex, hypertension, diabetes, hyperlipidemia, left atrial diameter, LVEF, and LVPWT, the regression model showed a significant association of aIAB with cerebral SVD score (OR =2.408, 95% CI, 1.082-5.366). CONCLUSIONS: Atrial cardiopathy indexed by aIAB was independently associated with a high burden of SVD in the brain. 2020 Quantitative Imaging in Medicine and Surgery. All rights reserved.
BACKGROUND: The latest evidence shows the association of atrial cardiopathy with embolic strokes of undetermined source. Advanced interatrial block (aIAB) is an electrophysiological mark of atrial cardiopathy. This study investigated the relationship between aIAB and the burden of silent cerebral small vessel diseases (SVD) on magnetic resonance imaging in the absence of atrial fibrillation (AF) and atrial flutter. METHODS: This cross-sectional study included 499 patients with normal left ventricular ejection fraction (LVEF), who were free of AF, atrial flutter, stroke, and acute coronary syndrome in our hospital. aIAB was ascertained by digital electrocardiograms. Left atrial diameter, LVEF, and left ventricular posterior wall thickness (LVPWT) were measured on echocardiograms. Based on the presence of 4 manifestations of SVD, including white matter hyperintensity (WMH), lacunes, microbleeds, and enlarged perivascular spaces (EPVS) on magnetic resonance imaging, an ordinal SVD score (range, 0-4) was devised to reflect the total burden of cerebral SVD. The ordinal regression model was used to explore the association of aIAB with SVD burden after adjusting for confounding factors. RESULTS: The mean age was 67.7 years, and 327 (65.5%) were male. A total of 23 (4.6%) patients had aIAB. The number of patients with cerebral SVD scores of 0, 1, 2, 3, and 4 was 92 (18.4%), 122 (24.4%), 190 (38.1%), 83 (16.6%), and 12 (2.4%), respectively. After adjusting for age, sex, hypertension, diabetes, hyperlipidemia, left atrial diameter, LVEF, and LVPWT, the regression model showed a significant association of aIAB with cerebral SVD score (OR =2.408, 95% CI, 1.082-5.366). CONCLUSIONS: Atrial cardiopathy indexed by aIAB was independently associated with a high burden of SVD in the brain. 2020 Quantitative Imaging in Medicine and Surgery. All rights reserved.
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