Sex differences of vascular brain lesions in patients with atrial fibrillation. Issue 2 (13th September 2022)

• Record Type: Journal Article
• Authors: Ceylan, Selinda; Aeschbacher, Stefanie; Altermatt, Anna; Sinnecker, Tim; Rodondi, Nicolas; Blum, Manuel; Coslovsky, Michael; Evers-Dörpfeld, Simone; Niederberger, Sacha; Conen, David; Osswald, Stefan; Kühne, Michael; Düring, Marco; Wuerfel, Jens; Bonati, Leo
• Other Names: author non-byline.; Aeschbacher Stefanie author non-byline.; Auberson Chloé author non-byline.; Blum Steffen author non-byline.; Bonati Leo H author non-byline.; Ceylan Selinda author non-byline.; Conen David author non-byline.; Evers-Doerpfeld Simone author non-byline.; Eken Ceylan author non-byline.; Girod Marc author non-byline.; Hennings Elisa author non-byline.; Herber Elena author non-byline.; Iten Vasco author non-byline.; Krisai Philipp author non-byline.; Kühne Michael author non-byline.; Lischer Mirko author non-byline.; Meyer-Zürn Christine author non-byline.; Meyre Pascal author non-byline.; Monsch Andreas U author non-byline.; Müller Christian author non-byline.; Osswald Stefan author non-byline.; Springer Anne author non-byline.; Sticherling Christian author non-byline.; Szucs Thomas author non-byline.; Völlmin Gian author non-byline.; Osswald Stefan author non-byline.; Kühne Michael author non-byline.; Aujesky Drahomir author non-byline.; Blum Manuel R author non-byline.; Fischer Urs author non-byline.; Fuhrer Juerg author non-byline.; Roten Laurent author non-byline.; Jung Simon author non-byline.; Mattle Heinrich author non-byline.; Adam Luise author non-byline.; Aubert Carole Elodie author non-byline.; Feller Martin author non-byline.; Loewe Axel author non-byline.; Moutzouri Elisavet author non-byline.; Schneider Claudio author non-byline.; Flückiger Tanja author non-byline.; Groen Cindy author non-byline.; Ehrsam Lukas author non-byline.; Hellrigl Sven author non-byline.; Nuoffer Alexandra author non-byline.; Rakovic Damiana author non-byline.; Schwab Nathalie author non-byline.; Wenger Rylana author non-byline.; Rodondi Nicolas author non-byline.; Beynon Christopher author non-byline.; Dillier Roger author non-byline.; Deubelbeiss Michèle author non-byline.; Eberli Franz author non-byline.; Franzini Christine author non-byline.; Juchli Isabel author non-byline.; Liedtke Claudia author non-byline.; Nadler Jacqueline author non-byline.; Obst Thayze author non-byline.; Roth Jasmin author non-byline.; Schlomowitsch Fiona author non-byline.; Schneider Xiaoye author non-byline.; Studerus Katrin author non-byline.; Tynan Noreen author non-byline.; Weishaupt Dominik author non-byline.; Müller Andreas author non-byline.; Fontana Simone author non-byline.; Kuest Silke author non-byline.; Scheuch Karin author non-byline.; Hischier Denise author non-byline.; Bonetti Nicole author non-byline.; Grau Alexandra author non-byline.; Villinger Jonas author non-byline.; Laube Eva author non-byline.; Baumgartner Philipp author non-byline.; Filipovic Mark author non-byline.; Frick Marcel author non-byline.; Montrasio Giulia author non-byline.; Leuenberger Stefanie author non-byline.; Rutz Franziska author non-byline.; Beer Jürg-Hans author non-byline.; Auricchio Angelo author non-byline.; Anesini Adriana author non-byline.; Camporini Cristina author non-byline.; Conte Giulio author non-byline.; Caputo Maria Luce author non-byline.; Regoli Francois author non-byline.; Moccetti Tiziano author non-byline.; Brenner Roman author non-byline.; Altmann David author non-byline.; Gemperle Michaela author non-byline.; Ammann Peter author non-byline.; Firmann Mathieu author non-byline.; Foucras Sandrine author non-byline.; Rime Martine author non-byline.; Hayoz Daniel author non-byline.; Berte Benjamin author non-byline.; Justi Virgina author non-byline.; Kellner-Weldon Frauke author non-byline.; Mehmann Brigitta author non-byline.; Meier Sonja author non-byline.; Roth Myriam author non-byline.; Ruckli-Kaeppeli Andrea author non-byline.; Russi Ian author non-byline.; Schmidt Kai author non-byline.; Young Mabelle author non-byline.; Zbinden Melanie author non-byline.; Kobza Richard author non-byline.; Vicari Luisa author non-byline.; Moschovitis Giorgio author non-byline.; Ehret Georg author non-byline.; Gallet Hervé author non-byline.; Guillermet Elise author non-byline.; Lazeyras Francois author non-byline.; Lovblad Karl-Olof author non-byline.; Perret Patrick author non-byline.; Tavel Philippe author non-byline.; Teres Cheryl author non-byline.; Shah Dipen author non-byline.; Lauriers Nathalie author non-byline.; Méan Marie author non-byline.; Salzmann Sandrine author non-byline.; Schläpfer Jürg author non-byline.; Grêt Andrea author non-byline.; Novak Jan author non-byline.; Vitelli Sandra author non-byline.; Stephan Frank-Peter author non-byline.; Frangi-Kultalahti Jane author non-byline.; Gallino Augusto author non-byline.; Valentino Marcello Di author non-byline.; Witassek Fabienne author non-byline.; Schwenkglenks Matthias author non-byline.; Würfel Jens author non-byline.; Altermatt Anna author non-byline.; Amann Michael author non-byline.; Düring Marco author non-byline.; Huber Petra author non-byline.; Ruberte Esther author non-byline.; Sinnecker Tim author non-byline.; Zuber Vanessa author non-byline.; Coslovsky Michael author non-byline.; Benkert Pascal author non-byline.; Dutilh Gilles author non-byline.; Markovic Milica author non-byline.; Neuschwander Pia author non-byline.; Simon Patrick author non-byline.; Schmid Ramun author non-byline.;
• Is Part Of: Open heart. Volume 9:Issue 2(2022)
• Publication Date: 2022-09-13
• Subjects: Atrial Fibrillation -- STROKE -- Atrial Flutter; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Patients -- Periodicals; 616.12005
• DOI: 10.1136/openhrt-2022-002033
• Languages: English
• ISSNs: 2398-595X

Abstract

Abstract : 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.