| Abstract | Aim: Age and female sex are associated with a higher risk of stroke in atrial fibrillation (AF).
We sought to determine whether advancing age and female sex are associated with higher atrial
fibrosis.
Methods and results: We conducted an observational cohort study of patients with AF enrolled
in the University of Utah AF Database and a non-AF control group who underwent lategadolinium enhancement magnetic resonance imaging (LGE-MRI) for atrial fibrosis
quantification. Participants with contraindications for contrast MRI scanning were excluded.
Nine hundred and eight consecutive men and women with AF and 15 non-AF controls were
included in this study. Left atrial fibrosis increased with age in both men and women with AF.
Women with AF (n = 316) were older than men (n = 592): mean age 68.7±11.6 vs. 64.9±11.7
years; P < 0.01, and had higher left atrial fibrosis compared with men 17.5 ± 10.1% vs. 15.3 ±
8.9%; P < 0.001. Women also had a higher prevalence of prior stroke than men (15.8% vs.
6.5%; P < 0.001). Age and sex relationships with atrial fibrosis remained significant in
multivariate analysis. Compared with the non-AF control group, patients with AF they had
significantly higher atrial fibrosis: 16.0 ± 9.4 vs. 5.5 ± 5.8%; P < 0.001.
Conclusions: Advancing age and female sex are associated with a higher burden of atrial
fibrosis in patients with AF. Women with a prior history of stroke also have higher fibrosis
than women and men without a history of stroke. Advanced fibrosis may explain the female
and age association with stroke in AF. |
| Abstract (croatian) | Cilj: Dob i ženski spol povezani su s većim rizikom za moždani udar u osoba s atrijskom
fibrilacijom (AF). Željeli smo utvrditi jesu li starija životna dob i ženski spol povezani s višom
razinom fibroze atrija.
Metode i rezultati: Proveli smo kohortnu studiju u koju smo uključili pacijente s AF koji su
bili upisani u bazu podataka na Sveučilištu Utah i kontrolnu skupinu bez AF, koja je
podvrgnuta magnetskoj rezonanciji s kasnim gadolinijskim kontrastnim pojačanjem prikaza
(engl. late-gadolinium enhancement magnetic resonance imaging, LGE-MRI) radi određivanja
atrijske fibroze. Osobe s kontraindikacijama za LGE-MRI pretragu su bile isključene. Devet
stotina i osam uzastopnih ispitanika muškog i ženskog spola s AF i 15 kontrola bez AF-a bilo
je uključeno u ovo istraživanje. Fibroza lijevog atrija se povećavala s dobi i kod muškaraca i
kod žena s AF. Žene s AF (n=316) bile su starije od muškaraca (n=592), s prosječnom dobi od
68,7 godina ± 11,6 u odnosu na 64,9 ± 11,7 godina u muškaraca (P<0,001) te su imale višu
razinu fibroze lijevog atrija u usporedbi s muškarcima (17,5 ± 10,1% nasuprot 15,3 ± 8,9%;
P<0,001). Žene su također imale veću prevalenciju prethodnog moždanog udara u usporedbi s
muškarcima (15,8% nasuprot 6,5%; P<0,001). Dob i spol bili su prediktori atrijske fibroze u
multivarijatnoj analizi. U usporedbi s kontrolnom skupinom koja nema AF, pacijenti s AF imali
su značajno višu razinu atrijske fibroze (16,0 ± 9,4 naspram 5,5 ± 5,8%; P<0,001).
Zaključci: Starija životna dob i ženski spol povezani su s većim teretom atrijske fibroze kod
pacijenata s AF. Žene koje imaju prethodni moždani udar također imaju i veću razinu atrijske
fibroze u usporedbi sa ženama i muškarcima koji nisu imali moždani udar. Uznapredovala
fibroza može objasniti povezanost između ženskog spola i starije životne dobi s moždanim
udarom kod AF. |
