Open Heart (Sep 2022)
Sex differences of vascular brain lesions in patients with atrial fibrillation
- 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
Affiliations
- Christian Müller
- 1 Cardiovascular Research Institute, University Hospital Basel, Basel, Switzerland
- Leo H Bonati
- 10 Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland
- Pascal Meyre
- 1 Division of Cardiology, Department of Medicine, University Hospital Basel, Basel, Switzerland
- Steffen Blum
- Division of Cardiology, University Hospital Basel, Basel, Switzerland
- Stefanie Aeschbacher
- 1 Department of Medicine, Cardiology Division, University Hospital Basel, Basel, Switzerland
- David Conen
- 11 Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Stefan Osswald
- 1 Department of Medicine, Cardiology Division, University Hospital Basel, Basel, Switzerland
- Urs Fischer
- Department of Neurology, lnselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Manuel R Blum
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Simon Jung
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Jens Wuerfel
- 4 Medical Image Analysis Center, Basel, Switzerland
- Christian Sticherling
- 1 Department of Medicine, Cardiology Division, University Hospital Basel, Basel, Switzerland
- Michael Kuhne
- Division of Cardiology, University Hospital Basel, Basel, Switzerland
- Philipp Krisai
- 1 Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital, Basel, Basel Stadt, Switzerland
- Matthias Schwenkglenks
- Epidemiology, Biostatistic und Prevention Institute, University of Zurich, Zurich, Switzerland
- Luise Adam
- research fellow
- Elisavet Moutzouri
- 4 University of Bern Institute of Primary Health Care, Bern, Switzerland
- Martin Feller
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Nathalie Schwab
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Claudio Schneider
- 2 Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Drahomir Aujesky
- professor
- Nicolas Rodondi
- 4 University of Bern Institute of Primary Health Care, Bern, Switzerland
- Karl-Olof Lovblad
- Division of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
- Michael Amann
- Department of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
- Richard Kobza
- 9 Department of Cardiology, Luzerner Kantonsspital, Luzern, Switzerland
- Marie Méan
- 3 Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Andreas Müller
- Institute of Psychology, Work and Organisational Psychology, University of Duisburg-Essen, Essen, Germany
- Giorgio Moschovitis
- 7 Division of Cardiology, Ospedale Regionale di Lugano-Civico e Italiano, Lugano, Switzerland
- Fabienne Witassek
- 4 Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Silke Küest
- Heart Clinic Zurich, Hirslanden Hospital Hirslanden, Zurich, Switzerland
- Sonja Meier
- consultant
- Jürg-Hans Beer
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland
- Damiana Rakovic
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Michael Coslovsky
- 1 Department of Medicine, Cardiology Division, University Hospital Basel, Basel, Switzerland
- Tiziano Moccetti
- Cardiology, Cardiocentro, Lugano, Switzerland
- Ramun Schmid
- 3Signal Processing, Schiller AG, Switzerland
- Augusto Gallino
- 1Division of Cardiology, Ospedale San Giovanni Bellinzona, Switzerland
- Carole Elodie Aubert
- 2 Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Georg Ehret
- 6Division of Cardiology, University of Geneva, Geneva, Switzerland
- Angelo Auricchio
- Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Ticino, Switzerland
- Giulio Conte
- Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Ticino, Switzerland
- Daniel Hayoz
- 2 Department of General Internal Medicine, Fribourg Cantonal Hospital, Fribourg, Switzerland
- Benjamin Berte
- Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland
- Nathalie Lauriers
- 1 Department of Cardiology, University Hospital, Lausanne, Switzerland
- Peter Ammann
- 8 Department of Cardiology, Kantonsspital Sankt Gallen, Sankt Gallen, Switzerland
- François Regoli
- Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
- Dipen Shah
- Laurent Roten
- Department of Cardiology, Swiss Cardiovascular Center Bern, University of Bern, Bern, Switzerland
- Marco Düring
- Institute for Stroke and Dementia Research, Medical Centre, Ludwig-Maximilians-University, Munich, Germany
- Pascal Benkert
- Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- Simone Evers-Dörpfeld
- 1 Department of Medicine, Cardiology Division, University Hospital Basel, Basel, Switzerland
- Elisa Hennings
- 1 Department of Medicine, Cardiology Division, University Hospital Basel, Basel, Switzerland
- Ceylan Eken
- 1 Department of Medicine, Cardiology Division, University Hospital Basel, Basel, Switzerland
- Selinda Ceylan
- 1 Department of Medicine, Cardiology Division, University Hospital Basel, Basel, Switzerland
- Anne Springer
- 1 Department of Medicine, Cardiology Division, University Hospital Basel, Basel, Switzerland
- Heinrich Mattle
- Tim Sinnecker
- 3Medical Image Analysis Center, Basel
- Leo Bonati
- Department of Neurology, University Hospital Basel, Basel, Switzerland
- Anna Altermatt
- MIAC AG and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Manuel Blum
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Sacha Niederberger
- Cardiology Division, Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
- 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
- 1Department of Neurology, University and University Hospital Zurich, Zurich, Switzerland
- 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
- DOI
- https://doi.org/10.1136/openhrt-2022-002033
- Journal volume & issue
-
Vol. 9,
no. 2
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.
