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J Stroke Cerebrovasc Dis. 2012 May;21(4):310-7. doi: 10.1016/j.jstrokecerebrovasdis.2010.09.004. Epub 2010 Nov 26.

Silent cerebral infarcts and cerebral white matter lesions in patients with nonvalvular atrial fibrillation.

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Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.



Nonvalvular atrial fibrillation (NVAF) is a well-known strong risk factor for stroke, although few studies have examined silent cerebral ischemic lesions in patients with NVAF. We investigated silent cerebral infarcts (SCIs) and cerebral white matter lesions and risk factors for stroke in NVAF patients.


Subjects included 71 consecutive patients with NVAF and 71 sex-and age-matched controls with sinus rhythm who had undergone MRI. Number, size, and localization of SCIs and severity of periventricular hyperintensity (PVH) and deep and subcortical white matter hyperintensity (DSWMH) on magnetic resonance imaging were analyzed. The risk factors and CHADS2 score for stroke were also investigated.


The number of SCIs was significantly larger and the rates of SCIs in the cortex/subcortex and deep white matter were higher in the NVAF group than in the control group. The DSWMH grade was also significantly higher in the NVAF group. NVAF was an independent risk factor for SCIs and DSWMH. The number of cortical and subcortical SCIs was significantly correlated with CHADS2 score.


Cortical/subcortical and deep white matter SCIs were more frequent and DSWMH grades were higher in NVAF patients compared with control subjects. CHADS2 score was an effective scheme not only in stroke risk but also in risk of SCI.

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