Atrial Cardiopathy in the Absence of Atrial Fibrillation Increases Risk of Ischemic Stroke, Incident Atrial Fibrillation, and Mortality and Improves Stroke Risk Prediction

Edwards, Jodi D.; Healey, Jeff S.; Fang, Jiming; Yip, Kathy; Gladstone, David J.

doi:10.1161/jaha.119.013227

Cited by 39 publications

(22 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The concept of atrial cardiopathy has been proposed as a potential cause of AF, and it can lead to thromboembolism due to left atrial function abnormality, even without AF [ 27 ]. Data from a large retrospective cohort from Canada indicated that, in the absence of AF, increased LAD significantly and independently increased the risk of ischemic stroke at 2 years with C-statistics ranging from 0.68 to 0.75 [ 28 ]. The combination of LAD and CHA 2 DS 2 -VASc score, even in patients without AF, significantly improved stroke risk prediction.…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Diameter in the Prediction of Thromboembolic Event and Death in Atrial Fibrillation

Krittayaphong

Winijkul

Sairat

2022

JCM

View full text Add to dashboard Cite

Background: This study aimed to determine the predictive value of left atrial diameter (LAD), and the incremental prognostic value of LAD in combination with CHA2DS2-VASc score for predicting thromboembolic event and all-cause death in patients with non-valvular atrial fibrillation (AF). Methods: This is a prospective study from 27 hospitals during 2014–2017. LADi is LAD data indexed by body surface area, and LADi in the 4th quartile (LADi Q4) was considered high. Results: A total of 2251 patients (mean age 67.4 years, 58.6% male) were enrolled. Mean follow-up duration was 32.3 months. Rates of thromboembolic events and all-cause death were significantly higher in LADi Q4 patients than in LADi Q1–3 patients (2.89 vs. 1.11 per 100 person-years, p < 0.001, and 7.52 vs. 3.13 per 100 person-years, p < 0.001, respectively). LADi Q4 is an independent predictor of thromboembolic events and all-cause death with an adjusted hazard ratio and 95% confidence interval of 1.94 (1.24–3.05) and 1.81 (1.38–2.37), respectively. LADi has incremental prognostic value on top of the CHA2DS2-VASc score with the increase in global chi-square for thromboembolism (p = 0.005) and all-cause death (p < 0.001). Conclusions: LADi is an independent predictor of thromboembolic event and has incremental prognostic value in combination with CHA2DS2-VASc score in AF patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Left Atrial Diameter in the Prediction of Thromboembolic Event and Death in Atrial Fibrillation

Krittayaphong

Winijkul

Sairat

2022

JCM

View full text Add to dashboard Cite

show abstract

“…Left atrial cardiopathy is the process of structural and electrical remodeling preceding clinically manifest AF. Markers of left atrial cardiopathy including increased P-wave terminal in lead V 1 , left atrial enlargement, and excessive atrial ectopy increase the risk of AF and have recently been identified as a direct risk factor for stroke in the absence of AF [60]. Further, preliminary studies have shown that left atrial cardiomyopathy may also increase the risk of cognitive decline [61], suggesting that detection of atrial cardiopathy might represent an important opportunity to improve the estimation of dementia risk in aging adults.…”

Section: Does the Heart Matter For Your White Matter? Novel Cardiac Markers Of Dementia Riskmentioning

confidence: 99%

Expanding the horizon of research into the pathogenesis of the white matter diseases: Proceedings of the 2021 Annual Workshop of the Albert Research Institute for White Matter and Cognition

et al. 2021

Self Cite

View full text Add to dashboard Cite

White matter pathologies are critically involved in the etiology of vascular cognitive impairment–dementia (VCID), Alzheimer’s disease (AD), and Alzheimer’s disease and related diseases (ADRD), and therefore need to be considered a treatable target ( Roseborough A, Hachinski V, Whitehead S. White matter degeneration - a treatable target? Roseborough et al. JAMA Neurol [Internet]. 2020 Apr 27;77(7):793–4, [ 1 ] . To help address this often-missed area of research, several workshops have been sponsored by the Leo and Anne Albert Charitable Trust since 2015, resulting in the incorporation of “The Albert Research Institute for White Matter and Cognition” in 2020. The first annual “Institute” meeting was held virtually on March 3–4, 2021. The Institute provides a forum and workspace for communication and support of the advancement of white matter science and research to better understand the evolution and prevention of dementia. It serves as a platform for young investigator development, to introduce new data and debate biology mechanisms and new ideas, and to encourage and support new research collaborations and directions to clarify how white matter changes, with other genetic and health risk factors, contribute to cognitive impairment. Similar to previous Albert Trust–sponsored workshops (Barone et al. in J Transl Med 14:1–14, [ 2 ]; Sorond et al. in GeroScience 42:81–96, [ 3 ]), established expert investigators were identified and invited to present. Opportunities to attend and present were also extended by invitation to talented research fellows and younger scientists. Also, updates on institute-funded research collaborations were provided and discussed. The summary that follows is a synopsis of topics and discussion covered in the workshop.

show abstract

“…heart failure, cognitive impairment, atrial cardiopathy, dementia, atrial fibrillation 2020; Edwards et al, 2020). While the link between AF and HF and cognition is clear, data on AC and cognition are scarce (Aldrugh et al, 2017;Rosler and Schnabel, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Potential biomarkers of AC include imaging, electrophysiological, and serum abnormalities. AC may also be a substrate for multiple primary cardiac disorders, including atrial fibrillation (AF) and heart failure (HF), and has been linked to increased risk for stroke and higher stroke mortality ( Ahmad et al, 2020 ; Edwards et al, 2020 ). While the link between AF and HF and cognition is clear, data on AC and cognition are scarce ( Aldrugh et al, 2017 ; Rosler and Schnabel, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Atrial cardiopathy and cognitive impairment

Myers

Jiménez‐Ruiz

Sposato

et al. 2022

Front. Aging Neurosci.

View full text Add to dashboard Cite

Cognitive impairment involves complex interactions between multiple pathways and mechanisms, one of which being cardiac disorders. Atrial cardiopathy (AC) is a structural and functional disorder of the left atrium that may be a substrate for other cardiac disorders such as atrial fibrillation (AF) and heart failure (HF). The association between AF and HF and cognitive decline is clear; however, the relationship between AC and cognition requires further investigation. Studies have shown that several markers of AC, such as increased brain natriuretic peptide and left atrial enlargement, are associated with an increased risk for cognitive impairment. The pathophysiology of cognitive decline in patients with AC is not yet well understood. Advancing our understanding of the relationship between AC and cognition may point to important treatable targets and inform future therapeutic advancements. This review presents our current understanding of the diagnosis of AC, as well as clinical characteristics and potential pathways involved in the association between AC and cognitive impairment.

show abstract

Atrial Cardiopathy in the Absence of Atrial Fibrillation Increases Risk of Ischemic Stroke, Incident Atrial Fibrillation, and Mortality and Improves Stroke Risk Prediction

Cited by 39 publications

References 54 publications

Left Atrial Diameter in the Prediction of Thromboembolic Event and Death in Atrial Fibrillation

Left Atrial Diameter in the Prediction of Thromboembolic Event and Death in Atrial Fibrillation

Expanding the horizon of research into the pathogenesis of the white matter diseases: Proceedings of the 2021 Annual Workshop of the Albert Research Institute for White Matter and Cognition

Atrial cardiopathy and cognitive impairment

Contact Info

Product

Resources

About