PO142 | CROSS-TALK BETWEEN HEART AND BRAIN IN ATRIAL FIBRILLATION: ASSOCIATIONS BETWEEN CARDIAC REMODELING AND CEREBROVASCULAR LESION BURDEN IN THE STRAT-AF STUDY
Abstract
Background. Atrial fibrillation is the most common arrhythmia, associated with increased risk of ischemic stroke and mortality. Neuroimaging has shown a high prevalence of cerebral small vessel disease markers in AF patients, but the underlying mechanisms remain unclear. Objectives. To investigate the association between microangiopathic and non-microangiopathic neuroimaging markers of cerebrovascular damage and cardiac morphological features in elderly atrial fibrillation patients on oral anticoagulants. Methods. We performed a cross-sectional analysis within the Strat-AF 2 study. From March 2021 to June 2022, we consecutively enrolled patients >65 years with AF on oral anticoagulants for thromboembolic prevention. All underwent clinical assessment, neuroimaging (magnetic resonance imaging, or computed tomography scan), and echocardiography. Results. A total of 179 patients were included (mean age 78.6 ± 6.7 years, 58% male): 100 underwent magnetic resonance imaging and 79 computed tomography. Non-lacunar infarcts were present in 26%, while 79.3% showed at least one cerebral small vessel disease marker. Mean indexed left atrial volume was 48.5 ± 19.8 mL/m². In multivariate analysis, non-paroxysmal atrial fibrillation was independently associated with non-lacunar infarcts (OR 2.95; 95% CI 1.07–8.12; p=0.036). Larger left atrial volume was independently associated with both moderate-to-severe medial temporal lobe atrophy (OR 1.025 per mL/m²; 95% CI 1.003–1.047; p=0.024) and lacunes (OR 1.008; 95% CI 1.010–1.017; p=0.05). Conclusions. In elderly AF patients on OAC, cardiac structural parameters were associated with both microangiopathic and non-microangiopathic brain lesions, even in the absence of prior ischemic stroke. Larger longitudinal studies are needed to confirm and clarify these associations.
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BibTeX
@article{alfano2026po142,
title = {{PO142 | CROSS-TALK BETWEEN HEART AND BRAIN IN ATRIAL FIBRILLATION: ASSOCIATIONS BETWEEN CARDIAC REMODELING AND CEREBROVASCULAR LESION BURDEN IN THE STRAT-AF STUDY}},
author = {Francesco Alfano},
journal = {Bleeding, Thrombosis and Vascular Biology},
year = {2026},
month = oct,
url = {https://www.btvb.org/btvb/article/view/958},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - PO142 | CROSS-TALK BETWEEN HEART AND BRAIN IN ATRIAL FIBRILLATION: ASSOCIATIONS BETWEEN CARDIAC REMODELING AND CEREBROVASCULAR LESION BURDEN IN THE STRAT-AF STUDY
AU - Francesco Alfano
PY - 2026
DA - 2026/10/26
JO - Bleeding, Thrombosis and Vascular Biology
UR - https://www.btvb.org/btvb/article/view/958
AB - Background. Atrial fibrillation is the most common arrhythmia, associated with increased risk of ischemic stroke and mortality. Neuroimaging has shown a high prevalence of cerebral small vessel disease markers in AF patients, but the underlying mechanisms remain unclear. Objectives. To investigate the association between microangiopathic and non-microangiopathic neuroimaging markers of cerebrovascular damage and cardiac morphological features in elderly atrial fibrillation patients on oral anticoagulants. Methods. We performed a cross-sectional analysis within the Strat-AF 2 study. From March 2021 to June 2022, we consecutively enrolled patients >65 years with AF on oral anticoagulants for thromboembolic prevention. All underwent clinical assessment, neuroimaging (magnetic resonance imaging, or computed tomography scan), and echocardiography. Results. A total of 179 patients were included (mean age 78.6 ± 6.7 years, 58% male): 100 underwent magnetic resonance imaging and 79 computed tomography. Non-lacunar infarcts were present in 26%, while 79.3% showed at least one cerebral small vessel disease marker. Mean indexed left atrial volume was 48.5 ± 19.8 mL/m². In multivariate analysis, non-paroxysmal atrial fibrillation was independently associated with non-lacunar infarcts (OR 2.95; 95% CI 1.07–8.12; p=0.036). Larger left atrial volume was independently associated with both moderate-to-severe medial temporal lobe atrophy (OR 1.025 per mL/m²; 95% CI 1.003–1.047; p=0.024) and lacunes (OR 1.008; 95% CI 1.010–1.017; p=0.05). Conclusions. In elderly AF patients on OAC, cardiac structural parameters were associated with both microangiopathic and non-microangiopathic brain lesions, even in the absence of prior ischemic stroke. Larger longitudinal studies are needed to confirm and clarify these associations.
SN - 2785-5309
ER -