Atrial fibrillation is associated with decreased total cerebral blood flow and brain perfusion
Atrial fibrillation is associated with decreased total cerebral blood flow and brain perfusion
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DOI：
10.1093/europace/eux220
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发表时间：
2018-08-01
期刊：
影响因子：
6.1
通讯作者：
Arnar, David O.
中科院分区：
文献类型：
--
作者：
Gardarsdottir, Marianna;Sigurdsson, Sigurdur;Arnar, David O.
目的心房颤动（AF）与认知功能障碍有关.此外，本发明还房颤患者的脑容量可能会减少。潜在原因可能包括脑微栓塞或由于心跳-心跳引起的每搏输出量减少。本研究的目的是测量脑血流量和估计全脑灌注在老年人与非AF。方法和结果颈部动脉血流量测量相位对比MRI和脑灌注估计在一个来自AGES-Reykjavik研究的大型队列。在MRI检查时，个体被分为三组：持续性AF、阵发性AF和无AF病史。在2291名参与者（平均年龄79.5岁）中，117名患有持续性AF，78名患有阵发性AF，但在AF成像时处于窦性心律。三组在其他心血管危险因素方面相似。持续性房颤组的平均脑血流量为472.1 mL/min，显著低于阵发性房颤组的512.3 mL/min（P < 0.05）和非房颤组的541.0 mL/min（P < 0.001）。持续性房颤组脑血流灌注最低，为46.4 mL/100 g/min，阵发性房颤组为50.9 mL/100 g/min，无房颤组为52.8 mL/100 g/min，两组比较差异有显著性（P <0.05）。
Aims Atrial fibrillation (AF) has been associated with cognitive impairment. Additionally, brain volume may be reduced in individuals with AF. Potential causes may include cerebral micro-embolism or reduced stroke volume due to the beat-to-beat variation in AF. The aims of this study were to measure cerebral blood flow and estimate whole brain perfusion in elderly individuals with and without AF.Methods and results Blood flow in the cervical arteries was measured with phase contrast MRI and brain perfusion estimated in a large cohort from the AGES-Reykjavik Study. Individuals were divided into three groups at the time of the MRI: persistent AF, paroxysmal AF, and no history of AF. Of 2291 participants (mean age 79.5 years), 117 had persistent AF and 78 had paroxysmal AF but were in sinus rhythm at the time of imaging AF. Those with persistent AF had lower cholesterol and used more anti-hypertensive medication and warfarin. The three groups were similar with regard to other cardiovascular risk factors. Those in the persistent AF group had significantly lower total cerebral blood flow on average, 472.1 mL/min, both when compared with the paroxysmal AF group, 512.3 mL/min (P < 0.05) and the no AF group, 541.0 mL/min (P < 0.001). Brain perfusion was lowest in the persistent AF group, 46.4 mL/100 g/min compared with the paroxysmal AF group, 50.9 mL/100 g/min in (P < 0.05) and those with no AF, 52.8 mL/100 g/min (P < 0.001).Conclusion Persistent AF decreases blood flow to the brain as well as perfusion of brain tissue compared with sinus rhythm.