Physical activity and brain health in patients with atrial fibrillation

SWISS-AF Investigators, Elena Herber, Stefanie Aeschbacher, Michael Coslovsky, Fabian Schwendinger, Elisa Hennings, Andreas Gasser, Marcello Di Valentino, Elia Rigamonti, Tobias Reichlin, Nicolas Rodondi, Seraina Netzer, Juerg H Beer, Annina Stauber, Andreas Müller, Peter Ammann, Tim Sinnecker, Marco Duering, Jens Wuerfel, David ConenMichael Kühne, Stefan Osswald, Leo H Bonati

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Background and purpose: Vascular brain lesions, such as ischemic infarcts, are common among patients with atrial fibrillation (AF) and are associated with impaired cognitive function. The role of physical activity (PA) in the prevalence of brain lesions and cognition in AF has not been investigated. Methods: Patients from the multicenter Swiss-AF cohort study were included in this cross-sectional analysis. We assessed regular exercise (RE; at least once weekly) and minutes of weekly PA using a validated questionnaire. We studied associations with ischemic infarcts, white matter hyperintensities, cerebral microbleeds, and brain volume on brain magnetic resonance imaging and with global cognition measured with a cognitive construct (CoCo) score. Results: Among 1490 participants (mean age = 72 ± 9 years), 730 (49%) engaged in RE. In adjusted regression analyses, RE was associated with a lower prevalence of ischemic infarcts (odds ratio [OR] = 0.78, 95% confidence interval [CI] = 0.63–0.98, p = 0.03) and of moderate to severe white matter hyperintensities (OR = 0.78, 95% CI = 0.62–0.99, p = 0.04), higher brain volume (β-coefficient = 10.73, 95% CI = 2.37–19.09, p = 0.01), and higher CoCo score (β-coefficient = 0.08, 95% CI = 0.03–0.12, p < 0.001). Increasing weekly PA was associated with higher brain volume (β-coefficient = 1.40, 95% CI = 0.65–2.15, p < 0.001). Conclusions: In AF patients, RE was associated with a lower prevalence of ischemic infarcts and of moderate to severe white matter disease, with larger brain volume, and with better cognitive performance. Prospective studies are needed to investigate whether these associations are causal. Until then, our findings suggest that patients with AF should be encouraged to remain physically active.

Originele taal-2English
Pagina's (van-tot)567-577
Aantal pagina's11
TijdschriftEuropean Journal of Neurology
Volume30
Nummer van het tijdschrift3
Vroegere onlinedatum28 dec 2022
DOI's
StatusPublished - mrt 2023

Bibliografische nota

Funding Information:
The Swiss‐AF study is supported by grants from the Swiss National Science Foundation (grant numbers 33CS30_148474, 33CS30_177520, 32473B_176178, and 32003B_197524), the Swiss Heart Foundation, the Foundation for Cardiovascular Research Basel, and the University of Basel.

Publisher Copyright:
© 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Copyright:
Copyright 2023 Elsevier B.V., All rights reserved.

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