title: Cerebral microbleeds and asymptomatic cerebral infarctions in patients with atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is a cardiac arrhythmia that does not infrequently induce ischemic strokes; however, little research has been reported on focal cerebral microangiopathic lesions in patients with AF. Recently cerebral microbleeds (CMBs) have been noticed for their potential implication in cerebral small vessel disease. Therefore, we had 2 goals in the present study: (1) to compare the prevalence of CMBs in patients with AF with that in patients without AF, and (2) to prove that CMBs could be a clinical predictive factor for the development of future cerebral microangiopathy in patients with AF without a history of symptomatic cerebral infarction in a prospective manner.
  
  
  METHODS
  We performed yearly brain magnetic resonance imaging (MRI) assessments for a maximum of 5 years in 131 patients with AF and 112 control patients. Seventy-seven patients with AF underwent more than 3 yearly MRI scans.
  
  
  RESULTS
  The Kaplan-Meier curve showed that the development of an asymptomatic cerebral infarction (ACI) was associated with the baseline presence of a CMB (P=.004). A multivariate Cox regression analysis revealed that the CMBs at baseline were significantly associated with an increment in not only the occurrence of ACIs (hazard ratio [HR], 5.414; 95% confidence interval [CI], 1.03-28.43; P=.046) but also in the consecutive development of CMBs (HR, 6.274; 95% CI, 1.43-27.56; P=.015).
  
  
  CONCLUSIONS
  Patients with AF had a significantly higher prevalence of CMBs. The presence of CMBs in the baseline MRI may predict the consequent onset of an ACI and increase in CMBs in patients with AF.
authors.affiliation: Department of Internal Medicine, Cardiovascular, Respiratory and Neurology Division, Asahikawa Medical University, Asahikawa, Hokkaido, Japan. Electronic address: tsukasa@asahikawa-med.ac.jp.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Saito
authors.affiliation: Department of Internal Medicine, Cardiovascular, Respiratory and Neurology Division, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kawamura
authors.affiliation: Department of Internal Medicine, Cardiovascular, Respiratory and Neurology Division, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Tanabe
authors.affiliation: Department of Internal Medicine, Cardiovascular, Respiratory and Neurology Division, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Asuka
authors.initials: A
authors.lastname: Asanome
authors.affiliation: Department of Internal Medicine, Cardiovascular, Respiratory and Neurology Division, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Kae
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Internal Medicine, Cardiovascular, Respiratory and Neurology Division, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Sawada
authors.affiliation: Department of Internal Medicine, Cardiovascular, Respiratory and Neurology Division, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Katayama
authors.affiliation: Department of Internal Medicine, Cardiovascular, Respiratory and Neurology Division, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sato
authors.affiliation: Department of Neurology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Aizawa
authors.affiliation: Department of Internal Medicine, Cardiovascular, Respiratory and Neurology Division, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hasebe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000473:pathology; D001921:Brain / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000473:pathology; D002544:Cerebral Infarction / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
keywords: Microbleeds; atrial fibrillation; cerebral infarction; cerebral small vessels