Fibrosis, Inflammation and Brain Health in Atrial Fibrillation.

Fibrosis, Inflammation and Brain Health in Atrial Fibrillation. The Norwegian Atrial Fibrillation and Stroke Study

Protocol synopsis Sponsor: Oslo University Hospital Title: Fibrosis, inflammation and cerebral infarction in patients with atrial fibrillation Study Design: The study is an observational prospective study of atrial fibrillation patients undergoing direct-current cardioversion. Primary Objective: To assess the prevalence and causes of new silent cerebral ischemic lesions after programmed direct-current cardioversion using diffusion-weighted sequences in brain MRI (DWMRI). Secondary Objectives: To study the impact of inflammation measured by biomarkers and cardiac 18F-FDG-PET on the risk for new silent cerebral ischemic lesions after direct-current cardioversion for AF. To assess the impact of fibrosis measured by biomarkers on the risk for new silent cerebral ischemic lesions after direct-current cardioversion for AF. To assess cognitive and cerebral structural and metabolic changes after direct-current cardioversion for AF using cognitive assessments and cerebral and cardiac 18F-FDG-PET before and 12 months after treatment. Number of Subjects: 50 Study Centers: Østfold Hospital Trust Duration of Study Participation: Enrollment: 18 months Follow-up period: 12 months Total Study Duration: 30 months Primary Endpoints: • Number of new small cerebral infarcts detected with DWMRI two weeks after direct current cardioversion. Secondary Endpoints: Rate of AF recurrence within 1 year after direct current cardioversion Change in levels of inflammation biomarkersfrom baseline to 12 months follow-up Change in levels of fibrosis biomarkers from baseline to 12 months follow-up Cognitive function at 12 months follow-up Changes in uptake pattern on cerebral 18F-FDG-PET from baseline to 12 months follow-up Changes in uptake pattern on cardiac 18F-FDG-PET from baseline to 12 months follow-up Brain volume at 12 months follow-up White matter volume 12 months follow-up Grey matter volume 12 months follow-up Cortical volume 12 months follow-up RSI-derived diffusion parameters 12 months follow-up: fast apparent diffusion coefficient, extracellular water fraction, fractional anisotropy; free water fraction; intracranial volume; NAWM: normal appearing white matter; neurite density; RSI: restriction spectrum imaging; sADC: slow apparent diffusion coefficient;restricted fractional anisotropy; white matter lesions.

Fibrosis, Inflammation and Brain Health in Atrial Fibrillation.

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