The Impact of Atrial Fibrillation Treatment Strategies on Cognitive Function

Bodagh, Neil; Kotadia, Irum; Gharaviri, Ali; Zelaya, Fernando; Birns, Jonathan; Bhalla, Ajay; Sommerville, Peter; Niederer, Steven; O’Neill, Mark; Williams, Steven E.

doi:10.3390/jcm12093050

Cited by 5 publications

(3 citation statements)

References 116 publications

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“…AF catheter ablation represents the cornerstone of the rhythm control strategy [3]. Theoretically, maintaining sinus rhythm could improve cerebral perfusion and could reduce cognitive decline prevalence in the long term [87,88]. In selected patients, such as some CAA patients, after an effective ablation procedure, we can, at least temporarily, suspend anticoagulant therapy, therefore reducing the bleeding risk.…”

Section: Catheter Ablation Of Atrial Fibrillationmentioning

confidence: 99%

When Atrial Fibrillation Meets Cerebral Amyloid Angiopathy: Current Evidence and Strategies

Merella,

Casu,

Chessa

et al. 2023

JCM

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Non-valvular atrial fibrillation (AF) and cerebral amyloid angiopathy (CAA) are two common diseases in elderly populations. Despite the effectiveness of oral anticoagulant therapy in cardioembolic stroke prevention, intracranial hemorrhage represents the most serious complication of these therapies. Cerebral amyloid angiopathy is one of the main risk factors for spontaneous intracranial bleeding, and this risk is highly increased by age and concomitant antithrombotic therapies. Cerebral amyloid angiopathy can be silent for years and then manifest with clinical features simulating TIA (TIA-mimics) or stroke in AF patients, pushing clinicians to rapidly start VKAs or DOACs, thus increasing the risk of intracranial bleeding if the diagnosis of CAA was unknown. Because the cerebral amyloid angiopathy is easily diagnosed with non-contrast MRI, suspecting the disease can avoid catastrophic complications. In this review, we will provide physicians managing anticoagulant therapies with key tips to familiarize themselves with cerebral amyloid angiopathy, with a focus on the possible clinical presentations and on the diagnostic criteria.

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Section: Catheter Ablation Of Atrial Fibrillationmentioning

confidence: 99%

When Atrial Fibrillation Meets Cerebral Amyloid Angiopathy: Current Evidence and Strategies

Merella,

Casu,

Chessa

et al. 2023

JCM

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“…A meta-analysis of nine studies found that direct oral anticoagulation may reduce the risk of dementia in Afib more so than Warfarin, though the authors urge caution against overinterpretation of their findings [94]. Key questions on the effects of Afib on post-stroke brain health persist, including the cognitive impact of different modalities of rhythm control or atrial appendage occlusion and how the burden of Afib (proportion of time someone is in Afib) affects cognition [95,96]. Most studies on the impact of Afib on cognition are among individuals without stroke; more studies are needed to specifically define the role of Afib in post-stroke physical and cognitive functioning and whether various treatment options have differential impacts on post-stroke functional status and brain health.…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Post-Stroke Brain Health Monitoring and Optimization: A Narrative Review

Stulberg,

Sachdev,

Murray

et al. 2023

JCM

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Significant advancements have been made in recent years in the acute treatment and secondary prevention of stroke. However, a large proportion of stroke survivors will go on to have enduring physical, cognitive, and psychological disabilities from suboptimal post-stroke brain health. Impaired brain health following stroke thus warrants increased attention from clinicians and researchers alike. In this narrative review based on an open timeframe search of the PubMed, Scopus, and Web of Science databases, we define post-stroke brain health and appraise the body of research focused on modifiable vascular, lifestyle, and psychosocial factors for optimizing post-stroke brain health. In addition, we make clinical recommendations for the monitoring and management of post-stroke brain health at major post-stroke transition points centered on four key intertwined domains: cognition, psychosocial health, physical functioning, and global vascular health. Finally, we discuss potential future work in the field of post-stroke brain health, including the use of remote monitoring and interventions, neuromodulation, multi-morbidity interventions, enriched environments, and the need to address inequities in post-stroke brain health. As post-stroke brain health is a relatively new, rapidly evolving, and broad clinical and research field, this narrative review aims to identify and summarize the evidence base to help clinicians and researchers tailor their own approach to integrating post-stroke brain health into their practices.

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“…In addition, modi able risk factors such as obesity, diabetes, high blood pressure and so on has been con rmed to be involved in the development of AF [5][6][7] . With AF continuous development, stroke, heart failure, myocardial infarction, even death would be happen [7][8][9][10] . So there are calling for ideal pharmacologic approaches to treat AF 11 .…”

Section: Introductionmentioning

confidence: 99%

C-C,N,S treats atrial fibrillation through regulating inflammatory procession: a study of network pharmacology research and gene set enrichment analysis validation

Yang,

Wang,

2023

Preprint

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Triangle drug combination of Citrus medica L.var.sarcodactylis Swingle, Naradostachys jatamansi DC. and Salvia miltiorrhiza Bge. (C-C,N,S) is usually appeared in atrial fibrillation-treating (AF) decoction and has good clinical effects. However, the core pathological process and mechanism of C-C,N,S intervening AF is unclear. So we intend to use network pharmacology and gene set enrichment analysis to explore the potential mechanism. We detected all compounds of C-C,N,S from CNKI database, predicted its bioactive compounds and potential anti-AF targets from related online platforms and databases. Then through PPI network, gene expression analyses, GO and KEGG pathway enrichment analysis on anti-AF targets, we determined the potential mechanism of C-C,N,S treating AF. Finally we used gene set enrichment analysis (GSEA) to validate the therapeutic effect of C-C,N,S. In conclusion, the therapeutic effect of C-C,N,S treating AF was focused on anti-inflammation. C-C,N,S can regulate inflammatory process and inhibit atrial remodeling and fibrosis through regulating TNF signaling pathway, IL-17 signaling pathway (MAPK signaling involved in) and PI3K-Akt signaling pathway. Some genes regulated by specific herbal medicine explained reason of the combination.

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The Impact of Atrial Fibrillation Treatment Strategies on Cognitive Function

Cited by 5 publications

References 116 publications

When Atrial Fibrillation Meets Cerebral Amyloid Angiopathy: Current Evidence and Strategies

When Atrial Fibrillation Meets Cerebral Amyloid Angiopathy: Current Evidence and Strategies

Post-Stroke Brain Health Monitoring and Optimization: A Narrative Review

C-C,N,S treats atrial fibrillation through regulating inflammatory procession: a study of network pharmacology research and gene set enrichment analysis validation

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