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Scientific article
Open access
English

Sex differences of vascular brain lesions in patients with atrial fibrillation

Published inOpen heart, vol. 9, no. 2, e002033
Publication date2022-09-13
First online date2022-09-13
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.

eng
Keywords
  • Atrial Fibrillation
  • Atrial Flutter
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / epidemiology
  • Brain / diagnostic imaging
  • Brain / pathology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infarction / complications
  • Infarction / pathology
  • Male
  • Sex Characteristics
  • Stroke
Citation (ISO format)
CEYLAN, Selinda et al. Sex differences of vascular brain lesions in patients with atrial fibrillation. In: Open heart, 2022, vol. 9, n° 2, p. e002033. doi: 10.1136/openhrt-2022-002033
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Identifiers
ISSN of the journal2053-3624
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Technical informations

Creation10/03/2022 2:37:00 PM
First validation10/03/2022 2:37:00 PM
Update time03/16/2023 10:32:50 AM
Status update03/16/2023 10:32:48 AM
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