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Atrial fibrillation and the interaction with stroke in relation to white matter lesion volumes: A population‐based study in 70‐year‐olds
Author(s) -
Rydén Lina,
Sacuiu Simona,
Wetterberg Hanna,
Najar Jenna,
Zettergren Anna,
Kern Silke,
Pereira Joana B,
Wahlund LarsOlof,
Westman Eric,
Skoog Ingmar
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.043296
Subject(s) - medicine , atrial fibrillation , stroke (engine) , cardiology , fluid attenuated inversion recovery , hyperintensity , population , cohort , lesion , magnetic resonance imaging , surgery , radiology , environmental health , engineering , mechanical engineering
Background Atrial fibrillation (Afib) increases the risk of stroke and dementia. However, the mechanisms underlying the association between Afib and dementia in the absence of manifest stroke are not that well understood. The aim of this study is to investigate the association between Afib and white matter lesion (WML) volumes in a population‐based sample of 70‐year‐olds. Method Data were obtained from the Gothenburg H70 birth cohort studies (H70). In 2014, 1203 participants were examined (response rate: 72%) and a subsample (n=791) underwent structural MRI using a fluid‐attenuated inversion recovery (FLAIR) sequence. WML volumes were measured on FLAIR images using the Lesion Segmentation Tool (LST) and subsequently log transformed for further statistical analyses. Afib was diagnosed through self‐report, ECG, and hospital register. Stroke was diagnosed through self‐report, proxy‐report, hospital register, and large infarctions (>15mm) on brain‐MRI. Linear regression was used to analyze the association between Afib and WML volumes, while adjusting for potential confounders. Result After excluding individuals with neurodegenerative diseases, valvular heart diseases, and incorrect WML segmentation, 779 individuals remained for statistical analyses. Of these, 65 individuals (8.3%) had Afib. Individuals with a history of Afib had larger WML volumes than individuals without Afib after adjusting for total intracranial volume and sex. However, after additional adjustments for cardiovascular and metabolic diseases, smoking, alcohol risk‐consumption, education and stroke, this association was no longer seen (β 0.1 (95% CI ‐0.2‐0.3); p=0.697). A significant interaction was found between Afib and stroke (p<0.001) regarding the association with WML volume. Therefore, we stratified the material by stroke and found that Afib was associated with increased WML volumes in individuals with stroke (β 1.1 (95% CI 0.0‐2.2); p=0.047) but not in those without. Conclusion This study suggests that Afib is associated with larger WML volumes in individuals with stroke but not in those without.