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Hyperintense Brain Lesions in Asymptomatic Low Risk Patients with Paroxysmal Atrial Fibrillation Undergoing Radiofrequency Pulmonary Vein Isolation

Background: The aim was to determine the occurrence, consequences and risk factors for brain white matter hyperintensities (WMH) assessed in magnetic resonance imaging (MRI) in low-risk patients with paroxysmal atrial fibrillation (AF) undergoing radiofrequency pulmonary vein isolation (PVI-RF). Met...

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Autores principales: Wieczorek, Joanna, Mizia-Stec, Katarzyna, Lasek-Bal, Anetta, Wieczorek, Piotr, Woźniak-Skowerska, Iwona, Wnuk-Wojnar, Anna M., Szydło, Krzysztof
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913160/
https://www.ncbi.nlm.nih.gov/pubmed/33546182
http://dx.doi.org/10.3390/jcm10040565
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author Wieczorek, Joanna
Mizia-Stec, Katarzyna
Lasek-Bal, Anetta
Wieczorek, Piotr
Woźniak-Skowerska, Iwona
Wnuk-Wojnar, Anna M.
Szydło, Krzysztof
author_facet Wieczorek, Joanna
Mizia-Stec, Katarzyna
Lasek-Bal, Anetta
Wieczorek, Piotr
Woźniak-Skowerska, Iwona
Wnuk-Wojnar, Anna M.
Szydło, Krzysztof
author_sort Wieczorek, Joanna
collection PubMed
description Background: The aim was to determine the occurrence, consequences and risk factors for brain white matter hyperintensities (WMH) assessed in magnetic resonance imaging (MRI) in low-risk patients with paroxysmal atrial fibrillation (AF) undergoing radiofrequency pulmonary vein isolation (PVI-RF). Methods: 74 patients with AF (median 58.5 years (IQR 50–63), 45 male) were included. Before and after a minimum of 6 months after PVI-RF, a brain MRI and a mini-mental state examination (MMSE) were performed. Results: Baseline WMH lesions were found in 55 (74.3%) patients and in 48 from 62 (77.4%) patients after PVI-RF. The WMH lesions were more frequent among older patients, with a higher CHA2DS2-Vasc (C—Congestive heart failure/LV dysfunction, H—Hypertension, A—Age, D—Diabetes mellitus, S—Stroke, V—Vascular Disease, Sc—Sex category). Factors affecting the severity of the WMH were: older age, the co-existence of the PFO and coronary artery disease (CAD). After a follow-up period, the factors predisposing to brain WMH lesions occurrence (age, higher BMI and CHA2DS2-Vasc score) and to the more advanced changes (age, higher CHA2DS2-Vasc score, CAD, PFO) were obtained. Conclusions: The presence and severity of cerebral microembolism are associated with age, higher CHA2DS2-Vasc score and the coexistence of PFO and CAD. PVI-RF procedure and its efficacy does not influence on MRI lesions. In this population, cerebral microembolism is not related to cognitive impairment.
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spelling pubmed-79131602021-02-28 Hyperintense Brain Lesions in Asymptomatic Low Risk Patients with Paroxysmal Atrial Fibrillation Undergoing Radiofrequency Pulmonary Vein Isolation Wieczorek, Joanna Mizia-Stec, Katarzyna Lasek-Bal, Anetta Wieczorek, Piotr Woźniak-Skowerska, Iwona Wnuk-Wojnar, Anna M. Szydło, Krzysztof J Clin Med Article Background: The aim was to determine the occurrence, consequences and risk factors for brain white matter hyperintensities (WMH) assessed in magnetic resonance imaging (MRI) in low-risk patients with paroxysmal atrial fibrillation (AF) undergoing radiofrequency pulmonary vein isolation (PVI-RF). Methods: 74 patients with AF (median 58.5 years (IQR 50–63), 45 male) were included. Before and after a minimum of 6 months after PVI-RF, a brain MRI and a mini-mental state examination (MMSE) were performed. Results: Baseline WMH lesions were found in 55 (74.3%) patients and in 48 from 62 (77.4%) patients after PVI-RF. The WMH lesions were more frequent among older patients, with a higher CHA2DS2-Vasc (C—Congestive heart failure/LV dysfunction, H—Hypertension, A—Age, D—Diabetes mellitus, S—Stroke, V—Vascular Disease, Sc—Sex category). Factors affecting the severity of the WMH were: older age, the co-existence of the PFO and coronary artery disease (CAD). After a follow-up period, the factors predisposing to brain WMH lesions occurrence (age, higher BMI and CHA2DS2-Vasc score) and to the more advanced changes (age, higher CHA2DS2-Vasc score, CAD, PFO) were obtained. Conclusions: The presence and severity of cerebral microembolism are associated with age, higher CHA2DS2-Vasc score and the coexistence of PFO and CAD. PVI-RF procedure and its efficacy does not influence on MRI lesions. In this population, cerebral microembolism is not related to cognitive impairment. MDPI 2021-02-03 /pmc/articles/PMC7913160/ /pubmed/33546182 http://dx.doi.org/10.3390/jcm10040565 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wieczorek, Joanna
Mizia-Stec, Katarzyna
Lasek-Bal, Anetta
Wieczorek, Piotr
Woźniak-Skowerska, Iwona
Wnuk-Wojnar, Anna M.
Szydło, Krzysztof
Hyperintense Brain Lesions in Asymptomatic Low Risk Patients with Paroxysmal Atrial Fibrillation Undergoing Radiofrequency Pulmonary Vein Isolation
title Hyperintense Brain Lesions in Asymptomatic Low Risk Patients with Paroxysmal Atrial Fibrillation Undergoing Radiofrequency Pulmonary Vein Isolation
title_full Hyperintense Brain Lesions in Asymptomatic Low Risk Patients with Paroxysmal Atrial Fibrillation Undergoing Radiofrequency Pulmonary Vein Isolation
title_fullStr Hyperintense Brain Lesions in Asymptomatic Low Risk Patients with Paroxysmal Atrial Fibrillation Undergoing Radiofrequency Pulmonary Vein Isolation
title_full_unstemmed Hyperintense Brain Lesions in Asymptomatic Low Risk Patients with Paroxysmal Atrial Fibrillation Undergoing Radiofrequency Pulmonary Vein Isolation
title_short Hyperintense Brain Lesions in Asymptomatic Low Risk Patients with Paroxysmal Atrial Fibrillation Undergoing Radiofrequency Pulmonary Vein Isolation
title_sort hyperintense brain lesions in asymptomatic low risk patients with paroxysmal atrial fibrillation undergoing radiofrequency pulmonary vein isolation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913160/
https://www.ncbi.nlm.nih.gov/pubmed/33546182
http://dx.doi.org/10.3390/jcm10040565
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