BACKGROUND Silent brain infarcts (SBI), a finding on neuroimaging, are associated with higher risk of future stroke. Atrial Fibrillation (AF) has been previously identified as a cause of SBI. OBJECTIVES The aim of this study is to determine the prevalence of and risk factors for SBI in patients with AF and low-to-moderate embolic risk according to CHADS2 and CHA2DS2VASc score. METHODS Patients with a history of AF based on medical records who scored 0-1 in the CHADS2 score were selected from the Seville urban area using the Andalusian electronic healthcare database (DIRAYA). Demographic and clinical data were collected and a 3T brain MRI was performed on patients older than 50 years and with absence of neurological symptoms. RESULTS 66 of the initial 443 patients (14.9%) and 41 of the 349 patients with low risk according to CHA2DS2VASc score (11.7%) presented at least 1 SBI. After adjusted multivariable analysis, an older age (OR 3.84, 95% CI 1.07-13.76) and left atrial (LA) enlargement (OR 3.13, 95% CI 1.15-8.55) were associated with SBI in the whole cohort, while only LA enlargement was associated with SBI in the low-risk cohort (OR 3.19, 95% CI 1.33-7.63). CONCLUSIONS LA enlargement on echocardiogram was associated with SBI in patients with AF and low or moderate embolic risk according to CHADS2 and in the low-risk population according to CHA2DS2VASc. Although further studies are needed, a neuroimaging screening might be justified in these patients to guide medical therapies to improve stroke prevention.

中文翻译：

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3T-MRI检测发现房颤患者无症状性脑梗死的患病率和危险因素。

背景技术沉默的脑梗塞（SBI）是神经影像学的发现，与未来中风的风险较高有关。房颤（AF）先前已被确定为SBI的病因。目的本研究旨在根据CHADS2和CHA2DS2VASc评分确定房颤和低至中度栓塞风险的SBI患病率和危险因素。方法使用安达卢西亚电子医疗数据库（DIRAYA）从塞维利亚市区中选出具有CHSDS2评分为0-1的具有医疗记录的AF史的患者。收集人口统计学和临床​​数据，并对50岁以上且无神经系统症状的患者进行3T脑MRI检查。结果最初的443例患者中有66例（14。根据CHA2DS2VASc评分（9.7％），在349位低危患者中，有9％和41位表现出至少1例SBI。经过调整的多变量分析后，在整个队列中，年龄较大（OR 3.84，95％CI 1.07-13.76）和左心房（LA）增大（OR 3.13，95％CI 1.15-8.55）与SBI相关，而仅LA增大在低危人群中与SBI相关（OR 3.19，95％CI 1.33-7.63）。结论根据CHADS2，根据心动图，LA超声心动图增大与房颤，低或中度栓塞风险以及根据CHA2DS2VASc对低危人群的SBI有关。尽管需要进一步的研究，但在这些患者中进行神经影像检查可能是合理的，以指导药物治疗以改善中风的预防。（07-13.76）和左心房（LA）增大（OR 3.13，95％CI 1.15-8.55）与整个队列中的SBI相关，而低危队列中只有LA增大与SBI相关（OR 3.19，95 ％CI 1.33-7.63）。结论根据CHADS2，根据心动图，LA超声心动图增大与房颤，低或中度栓塞风险以及根据CHA2DS2VASc对低危人群的SBI有关。尽管需要进一步的研究，但在这些患者中进行神经影像检查可能是合理的，以指导药物治疗以改善中风的预防。（07-13.76）和左心房（LA）增大（OR 3.13，95％CI 1.15-8.55）与整个队列中的SBI相关，而低危队列中只有LA增大与SBI相关（OR 3.19，95 ％CI 1.33-7.63）。结论根据CHADS2，根据心动图，LA超声心动图增大与房颤，低或中度栓塞风险以及根据CHA2DS2VASc对低危人群的SBI有关。尽管需要进一步的研究，但在这些患者中进行神经影像检查可能是合理的，以指导药物治疗以改善中风的预防。结论根据CHADS2，对于AF且低或中等栓塞风险的AF患者和根据CHA2DS2VASc的低危人群，超声心动图的LA增大与SBI有关。尽管需要进一步的研究，但在这些患者中进行神经影像检查可能是合理的，以指导药物治疗以改善中风的预防。结论根据CHADS2，根据心动图，LA超声心动图增大与房颤，低或中度栓塞风险以及根据CHA2DS2VASc对低危人群的SBI有关。尽管需要进一步的研究，但在这些患者中进行神经影像检查可能是合理的，以指导药物治疗以改善中风的预防。