학술논문
Sex differences of vascular brain lesions in patients with atrial fibrillation
Document Type
article
Author
Christian Müller; Leo H Bonati; Pascal Meyre; Steffen Blum; Stefanie Aeschbacher; David Conen; Stefan Osswald; Urs Fischer; Manuel R Blum; Simon Jung; Jens Wuerfel; Christian Sticherling; Michael Kuhne; Philipp Krisai; Matthias Schwenkglenks; Luise Adam; Elisavet Moutzouri; Martin Feller; Nathalie Schwab; Claudio Schneider; Drahomir Aujesky; Nicolas Rodondi; Karl-Olof Lovblad; Michael Amann; Richard Kobza; Marie Méan; Andreas Müller; Giorgio Moschovitis; Fabienne Witassek; Silke Küest; Sonja Meier; Jürg-Hans Beer; Damiana Rakovic; Michael Coslovsky; Tiziano Moccetti; Ramun Schmid; Augusto Gallino; Carole Elodie Aubert; Georg Ehret; Angelo Auricchio; Giulio Conte; Daniel Hayoz; Benjamin Berte; Nathalie Lauriers; Peter Ammann; François Regoli; Dipen Shah; Laurent Roten; Marco Düring; Pascal Benkert; Simone Evers-Dörpfeld; Elisa Hennings; Ceylan Eken; Selinda Ceylan; Anne Springer; Heinrich Mattle; Tim Sinnecker; Leo Bonati; Anna Altermatt; Manuel Blum; Sacha Niederberger; Chloé Auberson; Simone Evers-Doerpfeld; Marc Girod; Elena Herber; Vasco Iten; Mirko Lischer; Christine Meyer-Zürn; Andreas U Monsch; Thomas Szucs; Gian Völlmin; Juerg Fuhrer; Axel Loewe; Tanja Flückiger; Cindy Groen; Lukas Ehrsam; Sven Hellrigl; Alexandra Nuoffer; Rylana Wenger; Christopher Beynon; Roger Dillier; Michèle Deubelbeiss; Franz Eberli; Christine Franzini; Isabel Juchli; Claudia Liedtke; Jacqueline Nadler; Thayze Obst; Jasmin Roth; Fiona Schlomowitsch; Xiaoye Schneider; Katrin Studerus; Noreen Tynan; Dominik Weishaupt; Simone Fontana; Karin Scheuch; Denise Hischier; Nicole Bonetti; Alexandra Grau; Jonas Villinger; Eva Laube; Philipp Baumgartner; Mark Filipovic; Marcel Frick; Giulia Montrasio; Stefanie Leuenberger; Franziska Rutz; Adriana Anesini; Cristina Camporini; Maria Luce Caputo; Roman Brenner; David Altmann; Michaela Gemperle; Mathieu Firmann; Sandrine Foucras; Martine Rime; Virgina Justi; Frauke Kellner-Weldon; Brigitta Mehmann; Myriam Roth; Andrea Ruckli-Kaeppeli; Ian Russi; Kai Schmidt; Mabelle Young; Melanie Zbinden; Luisa Vicari; Hervé Gallet; Elise Guillermet; Francois Lazeyras; Patrick Perret; Philippe Tavel; Cheryl Teres; Sandrine Salzmann; Jürg Schläpfer; Andrea Grêt; Jan Novak; Sandra Vitelli; Frank-Peter Stephan; Jane Frangi-Kultalahti; Marcello Di Valentino; Jens Würfel; Petra Huber; Esther Ruberte; Vanessa Zuber; Gilles Dutilh; Milica Markovic; Pia Neuschwander; Patrick Simon
Source
Open Heart, Vol 9, Iss 2 (2022)
Subject
Language
English
ISSN
2053-3624
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.