Study On The Pathogenesis Of Cerebral Infarction In Patients With Non Valvular Atrial Fibrillation

【Background and Objective】Cerebral infarction is a serious complication of atrial fibrillation.On the mechanism of cerebral infarction which secondary to atrial fibrillation patients,cerebral embolism theory was considered to be the main reason before.but recently,in the clinial setting,we found that patients with non valvular atrial fibrillation(NVAF)and atrial fibrillation have significant differences between the incidence of cerebral infarction and imaging types.It is concluded that the mechanism between cerebral infarction secondary to non valvular atrial fibrillation(NVAFS)and cerebral infarction secondary to valvular atrial fibrillation(VAFS)may be different,but the research on this aspect is still uncertein.Therefore,the aim of this study was to investigate the possible hemodynamic mechanism of secondary cerebral infarction(NVAFS)in patients with nonvalvular atrial fibrillation(AF).【Method】A retrospective study was made on patients who had acute anterior circulation cerebral infarction.Then divided them into groups according their characteristics:(1)22 cases of valvular atrial fibrillation with cerebral infarction group(VAFS group)and 98 cases of non valvular atrial fibrillation with cerebral infarction group(NVAFS group);(2)158 cases of simple artery stenosis with cerebral infarction group(AS group),49 cases of simple non valvular atrial fibrillation with cerebral infarction group(NS group)and 49 cases of non valvular atrial fibrillation complicated with aterial stenosis in cerebral infarction group(CS group).Classify the imaging types of the cases chosen,then compare the similarities and differences of the imaging types and related baseline data(age,gender,history of hypertension,history of diabetes,D-Dimer,TC,TG,LDL-C,Fib,Hcy,left atrial diameter.etc.)between the VAFS and NVAFS groups,and among AS、NS、CS groups using statistical methods.【Result】The cerebral infarction secondary to valvular atrial fibrillation(VAFS) group and cerebral infarction secondary to non valvular atrial fibrillation(NVAFS)group have significant differences in imaging types,age,history of hypertension and diabetes(P < 0.05),but there were no differences in arterial stenosis,sex,TC,TG,Hcy,Fib,LDL-C and D-Dimer(P > 0.05);In the cerebral infarction secondary to valvular atrial fibrillation(VAFS)group,the main trunk infarction type occupies the first place,and non valvular atrial fibrillation with cerebral infarction group(NVAFS)is dominated by non trunk infarction,which watershed infarction type is the most(52.04%).The only non valvular atrial fibrillation with cerebral infarction group(NS),simple artery stenosis cerebral infarction group(AS)and mixed group(CS)similar in imaging classification,the three groups are major in the watershed infarction,and there are no differences among the three groups on the watershed infarction and non watershed infarction,trunk infarction and non trunk trunk infarction(P > 0.05).There are differences in gender,age,left atrial diameter,D-D,TG among the three groups(P < 0.05),but they have no variance in the history of hypertension,diabetes,Hcy,TC,LDL-C,Fib(P > 0.05).【Conclusion】The theory of hypoperfusion may be presumed to be the main cause of the pathogenesis of cerebral infarction in patients with nonvalvular atrial fibrillation(NVAFS).