Association of stroke lesion shape with newly detected atrial fibrillation - Results from the MonDAFIS study.
Abstract
Paroxysmal Atrial fibrillation (AF) is often clinically silent and may be missed by the usual diagnostic workup after ischemic stroke. We aimed to determine whether shape characteristics of ischemic stroke lesions can be used to predict AF in stroke patients without known AF at baseline. Lesion shape quantification on brain MRI was performed in selected patients from the intervention arm of the Impact of standardized MONitoring for Detection of Atrial Fibrillation in Ischemic Stroke (MonDAFIS) study, which included patients with ischemic stroke or TIA without prior AF. Multiple morphologic parameters were calculated based on lesion segmentation in acute brain MRI data. Multivariate logistic models were used to test the association of lesion morphology, clinical parameters, and AF. A stepwise elimination regression was conducted to identify the most important variables. A total of 755 patients were included. Patients with AF detected within 2 years after stroke (n = 86) had a larger overall oriented bounding box (OBB) volume (p = 0.003) and a higher number of brain lesion components (p = 0.008) than patients without AF. In the multivariate model, OBB volume (OR 1.72, 95%CI 1.29-2.35, p < 0.001), age (OR 2.13, 95%CI 1.52-3.06, p < 0.001), and female sex (OR 2.45, 95%CI 1.41-4.31, p = 0.002) were independently associated with detected AF. Ischemic lesions in patients with detected AF after stroke presented with a more dispersed infarct pattern and a higher number of lesion components. Together with clinical characteristics, these lesion shape characteristics may help in guiding prolonged cardiac monitoring after stroke.
Author
Pimentel, Bernardo Crespo
Ingwersen, Thies
Haeusler, Karl Georg
Schlemm, Eckhard
Forkert, Nils D
Rajashekar, Deepthi
Mouches, Pauline
Königsberg, Alina
Kirchhof, Paulus
Kunze, Claudia
Tütüncü, Serdar
Olma, Manuel C
Krämer, Michael
Michalski, Dominik
Kraft, Andrea
Rizos, Timolaos
Helberg, Torsten
Ehrlich, Sven
Nabavi, Darius G
Röther, Joachim
Laufs, Ulrich
Veltkamp, Roland
Heuschmann, Peter U
Cheng, Bastian
Endres, Matthias
Thomalla, Götz
Ingwersen, Thies
Haeusler, Karl Georg
Schlemm, Eckhard
Forkert, Nils D
Rajashekar, Deepthi
Mouches, Pauline
Königsberg, Alina
Kirchhof, Paulus
Kunze, Claudia
Tütüncü, Serdar
Olma, Manuel C
Krämer, Michael
Michalski, Dominik
Kraft, Andrea
Rizos, Timolaos
Helberg, Torsten
Ehrlich, Sven
Nabavi, Darius G
Röther, Joachim
Laufs, Ulrich
Veltkamp, Roland
Heuschmann, Peter U
Cheng, Bastian
Endres, Matthias
Thomalla, Götz
Citations
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Date
2022-05-25
Type
Article
Subject
Cardiology
Collections
Citation
Pimentel BC, Ingwersen T, Haeusler KG, Schlemm E, Forkert ND, Rajashekar D, Mouches P, Königsberg A, Kirchhof P, Kunze C, Tütüncü S, Olma MC, Krämer M, Michalski D, Kraft A, Rizos T, Helberg T, Ehrlich S, Nabavi DG, Röther J, Laufs U, Veltkamp R, Heuschmann PU, Cheng B, Endres M, Thomalla G. Association of stroke lesion shape with newly detected atrial fibrillation - Results from the MonDAFIS study. Eur Stroke J. 2022 Sep;7(3):230-237. doi: 10.1177/23969873221100895.
Journal / Source Title
European Stroke Journal
DOI
10.1177/23969873221100895
PMID
36082264
Publisher
SAGE Publications