# Correlation between atrial cardiomyopathy and total burden of cerebral small vessel disease in patients with acute ischemic stroke

## TL;DR

This study found that heart-related changes in the atrium are linked to more severe brain vessel damage in stroke patients.

## Contribution

The novel contribution is identifying a correlation between atrial cardiomyopathy and cerebral small vessel disease burden in acute ischemic stroke patients.

## Key findings

- Patients with atrial cardiomyopathy had higher total cerebral small vessel disease burden scores.
- Age, hypertension, and NIHSS score were independent risk factors for increased cerebral small vessel disease burden.

## Abstract

Atrial cardiomyopathy (ACM) and cerebral small vessel disease (CSVD) share common risk factors (e.g., hypertension, diabetes, dyslipidemia, aging) and pathophysiological mechanisms (e.g., inflammatory response, oxidative stress).

This study aimed to investigate the relationship between ACM and the total CSVD burden in patients with acute ischemic stroke (AIS).

We retrospectively enrolled eligible hospitalized AIS patients. Imaging markers were measured based on MRI data, including periventricular and deep white matter hyperintensities (WMH), enlarged perivascular spaces (EPVS), lacunes, cerebral microbleeds (CMBs), and brain atrophy. The total CSVD burden was calculated using the Wardlaw score. A P-wave terminal force in lead V1 (PTFV1) > 5,000 μV·ms was used to define atrial cardiomegaly (ACM), and a PTFV1 ≤ 5,000 μV·ms was adopted to define non-atrial cardiomegaly (NACM). Univariate and multivariate ordinal logistic regression analyses estimated the correlation between ACM and total CSVD burden.

Among 323 enrolled patients (mean age 67.67 years, 63.7% male), 83 were classified as ACM. Patients with ACM had significantly higher total Wardlaw scores (OR = 1.79, 95% CI = 1.07–3.02, p = 0.026). Age, hypertension, and NIHSS score were also independent risk factors for increased total burden [OR = 1.05 (95% CI = 1.02–1.07, p < 0.001), 2.09 (95% CI = 1.29–3.42, p = 0.003), and 1.13 (95% CI = 1.03–1.24, p = 0.009), respectively].

This study found a suggestive association between ACM and total CSVD burden in AIS patients, underscoring the importance of assessing ACM for evaluating CSVD risk factors in this patient population.