Author + information
- Received April 20, 2013
- Accepted May 20, 2013
- Published online November 19, 2013.
- Fiorenzo Gaita, MD∗∗ (, )
- Laura Corsinovi, MD, PhD∗,
- Matteo Anselmino, MD, PhD∗,
- Cristina Raimondo, MD∗,
- Martina Pianelli, MD∗,
- Elisabetta Toso, MD∗,
- Laura Bergamasco, Prof†,
- Carlo Boffano, MD‡,
- Maria Consuelo Valentini, MD§,
- Federico Cesarani, MD‖ and
- Marco Scaglione, MD¶
- ∗Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy
- †Department of Surgical Sciences, University of Turin, Turin, Italy
- ‡Neuroradiology Department, IRCCS Foundation, Neurological Institute “C. Besta,”, Milan, Italy
- §Division of Neuroradiology, Azienda Ospedaliera Città Della Salute e Della Scienza, Turin, Italy
- ‖Division of Radiology, Cardinal Guglielmo Massaia Hospital, Asti, Italy
- ¶Division of Cardiology, Cardinal Guglielmo Massaia Hospital, Asti, Italy
- ↵∗Reprint requests and correspondence:
Prof. Fiorenzo Gaita, Cardiology Division, Azienda Ospedaliera Città Della Salute e Della Scienza, University of Turin, Corso Bramante 88, 10126 Turin, Italy.
Objectives The aim of this study was to compare the prevalence of silent cerebral ischemia (SCI) and cognitive performance in patients with paroxysmal and persistent atrial fibrillation (AF) and controls in sinus rhythm.
Background Large registries have reported a similar risk for symptomatic stroke in both paroxysmal and persistent AF. The relationship among paroxysmal and persistent AF, SCI, and cognitive impairment has remained uncharted.
Methods Two hundred seventy subjects were enrolled: 180 patients with AF (50% paroxysmal and 50% persistent) and 90 controls. All subjects underwent clinical assessment, neurological examination, cerebral magnetic resonance, and the Repeatable Battery for the Assessment of Neuropsychological Status.
Results At least 1 area of SCI was present in 80 patients (89%) with paroxysmal AF, 83 (92%) with persistent AF (paroxysmal vs. persistent, p = 0.59), and 41 (46%) controls (paroxysmal vs. controls and persistent vs. controls, p < 0.01). The number of areas of SCI per subject was higher in patients with persistent AF than in those with paroxysmal AF (41.1 ± 28.0 vs. 33.2 ± 22.8, p = 0.04), with controls reporting lower figures (12.0 ± 26.7, p < 0.01 for both). Cognitive performance was significantly worse in patients with persistent and paroxysmal AF than in controls (Repeatable Battery for the Assessment of Neuropsychological Status scores 82.9 ± 11.5, 86.2 ± 13.8, and 92.4 ± 15.4 points, respectively, p < 0.01).
Conclusions Patients with paroxysmal and persistent AF had a higher prevalence and number of areas of SCI per patient than controls and worse cognitive performance than subjects in sinus rhythm.
The Hospital of Asti, in collaboration with the University of Turin, supported the present research protocol (magnetic resonance scans). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 20, 2013.
- Accepted May 20, 2013.
- 2013 American College of Cardiology Foundation