Blood–brain barrier disruption in atrial fibrillation: a potential contributor to the increased risk of dementia and worsening of stroke outcomes?

Ritambhara Aryal, Adjanie Patabendige*

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

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Abstract

Atrial fibrillation (AF) has become one of the most significant health problems worldwide, warranting urgent answers to currently pending questions on the effects of AF on brain function. Recent evidence has emerged to show an association between AF and an increased risk of developing dementia and worsening of stroke outcomes. A healthy brain is protected by the blood–brain barrier (BBB), which is formed by the endothelial cells that line cerebral capillaries. These endothelial cells are continuously exposed to shear stress (the frictional force generated by blood flow), which affects endothelial cell structure and function. Flow disturbances as experienced during AF can disrupt the BBB and leave the brain vulnerable to damage. Investigating the plausible mechanisms in detail, linking AF to cerebrovascular damage is difficult in humans, leading to paucity of available clinical data. Here, we discuss the available evidence for BBB disruption during AF due to altered cerebral blood flow, and how this may contribute to an increased risk of dementia and worsening of stroke outcomes.
Original languageEnglish
Article number200396
Pages (from-to)200396
JournalOpen Biology
Volume11
Issue number4
Early online date21 Apr 2021
DOIs
Publication statusPublished - 30 Apr 2021
Externally publishedYes

Keywords

  • Blood-brain barrier
  • atrial fibrillation
  • dementia
  • cognitive impairment
  • stroke
  • cerebrial blood flow

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