Frontiers in Cardiovascular Medicine (Sep 2024)
Blood pressure, brain lesions and cognitive decline in patients with atrial fibrillation
- Désirée Carmine,
- Désirée Carmine,
- Stefanie Aeschbacher,
- Stefanie Aeschbacher,
- Michael Coslovsky,
- Michael Coslovsky,
- Elisa Hennings,
- Elisa Hennings,
- Rebecca E. Paladini,
- Rebecca E. Paladini,
- Raffaele Peter,
- Raffaele Peter,
- Melanie Burger,
- Melanie Burger,
- Tobias Reichlin,
- Nicolas Rodondi,
- Nicolas Rodondi,
- Andreas S. Müller,
- Peter Ammann,
- Giulio Conte,
- Angelo Auricchio,
- Giorgio Moschovitis,
- Julia B. Bardoczi,
- Julia B. Bardoczi,
- Annina Stauber,
- Maria Luisa De Perna,
- Christine S. Zuern,
- Christine S. Zuern,
- Tim Sinnecker,
- Tim Sinnecker,
- Patrick Badertscher,
- Patrick Badertscher,
- Christian Sticherling,
- Christian Sticherling,
- Leo H. Bonati,
- David Conen,
- Philipp Krisai,
- Philipp Krisai,
- Stefan Osswald,
- Stefan Osswald,
- Michael Kühne,
- Michael Kühne
Affiliations
- Désirée Carmine
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Désirée Carmine
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Stefanie Aeschbacher
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Stefanie Aeschbacher
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Michael Coslovsky
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Michael Coslovsky
- Clinical Trial Unit Basel, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- Elisa Hennings
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Elisa Hennings
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Rebecca E. Paladini
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Rebecca E. Paladini
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Raffaele Peter
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Raffaele Peter
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Melanie Burger
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Melanie Burger
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Tobias Reichlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Nicolas Rodondi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Andreas S. Müller
- Department of Cardiology, Triemli Hospital Zürich, Zürich, Switzerland
- Peter Ammann
- Department of Cardiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Giulio Conte
- Division of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland
- Angelo Auricchio
- Division of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland
- Giorgio Moschovitis
- Division of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland
- Julia B. Bardoczi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Julia B. Bardoczi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Annina Stauber
- Department of Cardiology, Triemli Hospital Zürich, Zürich, Switzerland
- Maria Luisa De Perna
- Division of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland
- Christine S. Zuern
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Christine S. Zuern
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Tim Sinnecker
- 0Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
- Tim Sinnecker
- 1Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Patrick Badertscher
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Patrick Badertscher
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Christian Sticherling
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Christian Sticherling
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Leo H. Bonati
- 2Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
- David Conen
- 3Population Health Research Institute, McMaster University, Hamilton, ON, Canada
- Philipp Krisai
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Philipp Krisai
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Stefan Osswald
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Stefan Osswald
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Michael Kühne
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- Michael Kühne
- Department of Cardiology/Electrophysiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- DOI
- https://doi.org/10.3389/fcvm.2024.1449506
- Journal volume & issue
-
Vol. 11
Abstract
BackgroundThe influence of atrial fibrillation (AF) and blood pressure (BP) on brain lesions and cognitive function is unclear. We aimed to investigate the association of BP with different types of brain lesions and cognitive decline in patients with AF.MethodsOverall, 1,213 AF patients underwent standardized brain magnetic resonance imaging at baseline and after 2 years, as well as yearly neurocognitive testing. BP was measured at baseline and categorized according to guidelines. New lesions were defined as new or enlarged brain lesions after 2 years. We defined cognitive decline using three different neurocognitive tests. Logistic and Cox regression analyses were performed to examine the associations of BP with new brain lesions and cognitive decline.ResultsThe mean age was 71 ± 8.4 years, 74% were male and mean BP was 135 ± 18/79 ± 12 mmHg. New ischemic lesions and white matter lesions were found in 5.4% and 18.4%, respectively. After multivariable adjustment, BP was not associated with the presence of new brain lesions after 2 years. There was no association between BP and cognitive decline over a median follow-up of 6 years when using the Montreal Cognitive Assessment or Digit Symbol Substitution Test. However, BP categories were inversely associated with cognitive decline using the Semantic Fluency Test, with the strongest association in patients with hypertension grade 1 [Hazard Ratio (95% Confidence Interval) 0.57(0.42 to 0.77)], compared to patients with optimal BP (p for linear trend: 0.025).ConclusionsIn a large cohort of AF patients, there was no association between BP and incidence of brain lesions after 2 years. Also, there was no consistent association between BP and cognitive decline over a follow-up of 6 years. Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT02105844, Identifier (NCT02105844).
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