Association of Atrial Fibrillation With White Matter Disease The ARIC Study

• Type of Material: Article
• Authors: Iris Yuefan Shao, Emory University; Melinda C. Power, George Washington University; Thomas Mosley, University of Mississippi; Clifford Jack, Mayo Clinic; Rebecca F. Gottesman, Johns Hopkins University; Lin Y. Chen, University of Minnesota; Faye L. Norby, University of Minnesota; Elsayed Z. Soliman, Wake Forest University; Alvaro Alonso, Emory University
• Language: English
• Date: 2019-04-01
• Publisher: Lippincott Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 American Heart Association, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1161/STROKEAHA.118.023386
• Title of Journal or Parent Work: Stroke
• Volume: 50
• Issue: 4
• Start Page: 989
• End Page: 991
• Grant/Funding Information: This work was additionally supported by American Heart Association grant 16EIA26410001 (Alonso).; Neurocognitive data is collected by U01 HL096812, HL096814, HL096899, HL096902, HL096917 with previous brain MRI examinations funded by R01-HL70825.; The ARIC study has been funded in whole or in part with Federal funds from the NHLBI/NIH under Contract nos. (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I).
• Keywords: Life Sciences & Biomedicine; Hyper-intensities; dementia; leukoencephalopathies; Alzheimer's disease; Science & Technology; cognitive dysfunction; atrial fibrillation; Cognitive decline; Cardiovascular System & Cardiology; Clinical Neurology; Peripheral Vascular Disease; Neurosciences & Neurology; white matter
• Research Categories: Health Sciences, Pathology; Psychology, Cognitive; Biology, Neuroscience; Health Sciences, Epidemiology

Abstract

Background and Purpose: Evidence suggests that atrial fibrillation (AF) is associated with increased risk of cognitive decline and dementia, even in the absence of stroke. White matter disease (WMD) is a potential mechanism linking AF to cognitive impairment. In this study, we explored the association between prevalent AF and WMD. Methods: We performed a cross-sectional analysis of participants attending the ARIC-NCS (Atherosclerosis Risk in Communities-Neurocognitive Study) in 2011 to 2013 who underwent brain magnetic resonance imaging. AF was ascertained from study visit electrocardiograms or prior hospitalization codes. Extent of WMD was defined by measures of white matter (WM) microstructural integrity and WM hyperintensity volume. Multivariable linear regression models were used to assess the association between AF and WMD. Results: Among 1899 participants (mean age, 76 years; 28% black; 60% women), 133 (7%) had prevalent AF. After multivariable adjustment, differences between participants with and without AF were -0.001 (95% CI, -0.006 to 0.004) for global WM fractional anisotropy, 0.031×10-4 mm2/s (95% CI, -0.075 to 0.137) for global WM mean diffusivity, and 0.08 mm3 (95% CI, -0.14 to 0.30) for WM hyperintensity volume. Conclusions: The results suggest that there is no association between prevalent AF and WMD.