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Cardiac wall motion abnormality as a predictor for undetermined stroke with embolic lesion-pattern.

Abstract：

OBJECTIVES:Several strokes of potential embolism do not clearly meet the definitions of embolic stroke with unknown source, cryptogenic stroke, or cardioembolic (CE) stroke. Considering the high mortality and recurrence of CE strokes, it is very important to detect treatable cardiac sources of embolism. Although regional wall motion abnormality (RWMA) of the left ventricle (LV) seems to be related to CE stroke, association between cerebral embolic risk and RWMA remains unclear. The purpose of this study was to investigate the influence of RWMA on undetermined stroke with embolic lesion-pattern (USELP). PATIENTS AND METHODS:Among a total of 2327 patients with acute ischemic stroke, we excluded 148 patients without a transthoracic echocardiography (TTE). According to a stepwise approach, we excluded patients without an embolic lesion-pattern. Finally, we divided patients into two groups (USELP, 119, and non-embolic stroke, 1237). We classified patients' RWMAs into three major arterial territories according to the standard 17-segment model of TTE. RESULTS:Among the included 1356 patients, those with USELP had larger internal dimension at diastole and systole in LV, reduced LV ejection fraction, increased E/A ratios, mitral valve disease, and RWMA. After adjusting for multiple variables, binary logistic regression revealed that RWMA was significantly associated with USELP (OR 7.02, 95 % CI: 3.51-14.01, p<0.001). CONCLUSION:This study provides significant information to support that RWMA can be a predictor for undetermined embolic stroke. In this regard, RWMA were highly correlated with patients whose imaging supported an embolic source compared to those without this radiographic pattern.

journal_name

Clin Neurol Neurosurg

journal_title

Clinical neurology and neurosurgery

authors

Kim Y,Kim TJ,Lee SH

doi

10.1016/j.clineuro.2020.105677

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

105677

eissn

0303-8467

issn

1872-6968

pii

S0303-8467(20)30020-2

journal_volume

191

pub_type

杂志文章

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