دورية أكاديمية
أعرض في EDS

Left Atrial Function Is Impaired in Some Patients With Stroke of Undetermined Etiology: Potential Implications for Evaluation and Therapy.

التفاصيل البيبلوغرافية
العنوان: Left Atrial Function Is Impaired in Some Patients With Stroke of Undetermined Etiology: Potential Implications for Evaluation and Therapy.
المؤلفون: Sanchis L; Departamento de Cardiología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Spain. Electronic address: lsanchisruiz@gmail.com., Montserrat S; Departamento de Cardiología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Spain., Obach V; Departamento de Neurología, Hospital Clínic, Barcelona, Spain., Cervera Á; Departamento de Neurología, Hospital Clínic, Barcelona, Spain., Chamorro Á; Departamento de Neurología, Hospital Clínic, Barcelona, Spain., Vidal B; Departamento de Cardiología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Spain., Mas-Stachurska A; Departamento de Cardiología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Spain., Bijnens B; ICREA-Universidad Pompeu Fabra, Barcelona, Spain., Sitges M; Departamento de Cardiología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Spain.
المصدر: Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2016 Jul; Vol. 69 (7), pp. 650-6. Date of Electronic Publication: 2016 Mar 03.
نوع المنشور: Journal Article
اللغة: English; Spanish; Castilian
بيانات الدورية: Publisher: Elsevier Doyma Country of Publication: Spain NLM ID: 101587954 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1885-5857 (Electronic) Linking ISSN: 18855857 NLM ISO Abbreviation: Rev Esp Cardiol (Engl Ed) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Barcelona : Elsevier Doyma
مواضيع طبية MeSH: Anti-Arrhythmia Agents/*therapeutic use , Atrial Fibrillation/*complications , Atrial Function, Left/*physiology , Brain Ischemia/*etiology , Heart Atria/*physiopathology, Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/therapy ; Brain Ischemia/diagnosis ; Brain Ischemia/physiopathology ; Echocardiography ; Female ; Follow-Up Studies ; Heart Atria/diagnostic imaging ; Humans ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors
مستخلص: Introduction and Objectives: Stroke etiology remains undetermined in up to 30% of cases. Paroxysmal atrial fibrillation is found in 20% to 28% of patients with stroke initially classified as being of undetermined etiology. The aim of our study was to analyze left atrial function in ischemic stroke patients to identify patterns associated with cardioembolic etiology and to determine whether the patterns identified can be found in individuals initially classified as having a stroke of undetermined etiology.
Methods: We studied a cohort of in-hospital ischemic stroke patients referred for transthoracic echocardiography. Treating neurologists determined stroke etiology based on the TOAST classification. Left atrial contractile function was assessed using 2-dimensional echocardiography to determine their ejection fraction and speckle tracking to measure left atrial strain rate: a-wave. Left atrial function was compared between stroke etiology subgroups and healthy controls.
Results: Ninety-seven patients (aged 67±15 years) with ischemic stroke (16.5% large-artery atherosclerosis, 15.5% small-vessel occlusion, 11.3% cardioembolic, 5.1% other determined etiology, 51.1% undetermined etiology) and 10 healthy volunteers (aged 63±7 years) were included. Left atrial ejection fraction was significantly decreased only in patients with stroke of cardioembolic and undetermined etiology compared with the control group (31.5±17.2%, 40.2±17.1%, and 59.1±8.4%, respectively; P=.004). The left atrial strain rate was significantly lower in patients with stroke caused by cardioembolic or undetermined etiology, or large-artery atherosclerosis compared with controls (-0.86±0.49, -1.31±0.56, -1.5±0.47, -2.37±1.18, respectively; P<.001).
Conclusions: Patients with stroke of undetermined etiology with left atrial function (ejection fraction and strain) similar to that of cardioembolic stroke patients may be misclassified and could potentially benefit from prolonged electrocardiography monitoring. Left atrial function analysis (ejection fraction and strain) might help to identify potential cardioembolic sources in patients with stroke of undetermined etiology.
(Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
فهرسة مساهمة: Keywords: Cardiogenic stroke; Ictus cardioembólico; Ictus criptogénico; Ictus isquémico; Ischemic stroke; Left atrial strain; Speckle tracking; Strain auricular izquierdo; Undetermined etiology stroke
المشرفين على المادة: 0 (Anti-Arrhythmia Agents)
تواريخ الأحداث: Date Created: 20160308 Date Completed: 20170411 Latest Revision: 20170411
رمز التحديث: 20221213
DOI: 10.1016/j.rec.2015.11.033
PMID: 26949013
قاعدة البيانات: MEDLINE
الوصف
تدمد:1885-5857
DOI:10.1016/j.rec.2015.11.033