RT Journal Article
SR Electronic
T1 Sex differences of vascular brain lesions in patients with atrial fibrillation
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e002033
DO 10.1136/openhrt-2022-002033
VO 9
IS 2
A1 Selinda Ceylan
A1 Stefanie Aeschbacher
A1 Anna Altermatt
A1 Tim Sinnecker
A1 Nicolas Rodondi
A1 Manuel Blum
A1 Michael Coslovsky
A1 Simone Evers-Dörpfeld
A1 Sacha Niederberger
A1 David Conen
A1 Stefan Osswald
A1 Michael Kühne
A1 Marco Düring
A1 Jens Wuerfel
A1 Leo Bonati
A1 ,
YR 2022
UL http://openheart.bmj.com/content/9/2/e002033.abstract
AB Objective To examine sex differences in prevalence, volume and distribution of vascular brain lesions on MRI among patients with atrial fibrillation (AF).Methods In this cross-sectional analysis, we included 1743 patients with AF (27% women) from the multicentre Swiss Atrial Fibrillation study (SWISS-AF) with available baseline brain MRI. We compared presence and total volume of large non-cortical or cortical infarcts (LNCCIs), small non-cortical infarcts, microbleeds (MB) and white matter hyperintensities (WMH, Fazekas score ≥2 for moderate or severe degree) between men and women with multivariable logistic regression. We generated voxel-based probability maps to assess the anatomical distribution of lesions.Results We found no strong evidence for an association of female sex with the prevalence of all ischaemic infarcts (LNCCI and SNCI combined; adjusted OR 0.86, 95% CI 0.67 to 1.09, p=0.22), MB (adjusted OR 0.91, 95% CI 0.68 to 1.21, p=0.52) and moderate or severe WMH (adjusted OR 1.15, 95% CI 0.90 to 1.48, p=0.27). However, total WMH volume was 17% larger among women than men (multivariable adjusted multiplicative effect 1.17, 95% CI 1.01 to 1.35; p=0.04). Lesion probability maps showed a right hemispheric preponderance of ischaemic infarcts in both men and women, while WMH were distributed symmetrically.Conclusion Women had higher white matter disease burden than men, while volume and prevalence of other lesions did not differ. Our findings highlight the importance of controlling risk factors for cerebral small vessel disease in patients with AF, especially among women.Data are available upon reasonable request. Deidentified participant data are available from selinda.ceylan@hotmail.com. Swiss AF protocol is available in the supplementary materials.