Abstract WP23: Determining The Association Between Atrial Cardiopathy And Cerebral Microbleeds In Ischemic Stroke Patients

Abstract

Introduction: Cerebral microbleeds (CMB) are frequently found in individuals with atrial fibrillation (AF) or ischemic stroke (IS), but whether atrial cardiopathy among IS patients is associated with CMB is unknown. We hypothesize that atrial cardiopathy is associated with increased risk of CMB. Methods: Inclusion criteria were IS patients admitted to Johns Hopkins (2015-2019) with transthoracic echocardiography, and electrocardiography. CMB were defined per established criteria as small, round hypo-intensities on T2* susceptibility weighted imaging or gradient recalled echo MRI sequences. Atrial cardiopathy was defined as the presence of ≥1: left atrium (LA) diameter >4.0 cm (males) or >3.8 cm (females), PR interval >200 ms, or NT-pro BNP >250 pg/mL. Multivariable or multinomial logistic regression was used to determine the association between atrial cardiopathy, and CMB presence or number, each, adjusted for potential confounders. Results: Patients (N=150) were mean age 61 years (range 22-98), 42% female, 59% black, and 42% were on anti-thrombotic medications. 54 (36%) participants had ≥1 CMB (range 0-10, IQR 0-7). 65 (43%) patients had atrial cardiopathy (46 with enlarged LA diameter, 15 with elongated PR interval, 16 with elevated NT-pro BNP). Age (67 years vs. 57 years, p<0.001) and AF (N=18 vs. N=12, p=0.032) differed based on atrial cardiopathy status. Atrial cardiopathy was associated with higher odds of any CMB (OR 2.41, 95% CI 1.22-4.79) but not after adjustment (Table 1). Atrial cardiopathy was associated with lobar CMB (OR 2.33, 95% CI 1.01-5.37, Model 3) but not with deep (OR 0.45, 95% CI 0.13-1.54, Model 3). There was a non-statistically significant higher relative risk of having 1 or >1 CMBs (vs. none) among those with atrial cardiopathy. Conclusion: In this study, we found a significant association between atrial cardiopathy and lobar CMB in IS patients, suggesting that atrial cardiopathy may increase subclinical embolic risk.