Body weight after stroke: lessons from the obesity paradox.

Abstract:

BACKGROUND AND PURPOSE:Outcome after acute stroke is determined to a large extent by poststroke complications. Nutritional status and metabolic balance may substantially contribute to outcome after stroke. Key mechanisms of stroke pathophysiology can induce systemic catabolic imbalance with impaired metabolic efficiency and degradation of body tissues. SUMMARY:Tissue wasting, sarcopenia, and cachexia may impair and delay poststroke rehabilitation and worsen the prognosis. Although current guidelines for secondary prevention after stroke recommend weight reduction, increasing evidence suggests that patients who are overweight and mildly obese may actually have a better outcome. An "obesity paradox" has been identified to describe the contrasting impact of being overweight in patients with chronic illness compared with healthy populations. We present an overview on the metabolic regulation in patients with stroke and evaluate current data on the impact of body weight and weight change after stroke. The emerging picture suggests that being overweight and obese may impact patients with stroke differently than it does healthy subjects. CONCLUSIONS:We propose that current knowledge on obesity and its management in primary prevention cannot be transferred to patients with established stroke. Systematic studies on changes in body composition after stroke and on treatment options are warranted to establish the pathophysiology and evidence-driven management of nutritional status in these patients.

journal_name

Stroke

journal_title

Stroke

authors

Scherbakov N,Dirnagl U,Doehner W

doi

10.1161/STROKEAHA.111.619163

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

3646-50

issue

12

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.111.619163

journal_volume

42

pub_type

杂志文章

相关文献

STROKE文献大全
  • The pilot Stroke Data Bank: definition, design, and data.

    abstract::Four university centers collaborated to contribute 1158 patients with acute episodes of cerebrovascular disease to the pilot Stroke Data Bank, initiated by NINCDS in 1978. During the pilot project a standard set of data collection forms were developed and used at each of the collaborating centers. Data on clinical cou...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.15.4.740

    authors: Kunitz SC,Gross CR,Heyman A,Kase CS,Mohr JP,Price TR,Wolf PA

    更新日期:1984-07-01 00:00:00

  • Prognosis for survival after an initial stroke.

    abstract:BACKGROUND AND PURPOSE:We studied prognosis for survival after an initial stroke in 662 patients who survived at least 30 days after onset while taking into account age, sex, the number of neurological deficits from the initial stroke, stroke type, and five selected medical conditions: hypertension, myocardial infarcti...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.11.2011

    authors: Lai SM,Alter M,Friday G,Sobel E

    更新日期:1995-11-01 00:00:00

  • Mechanism of in-hospital cerebral ischemia.

    abstract::Of 171 patients evaluated prospectively and consecutively for cerebral ischemia, 26 (15%) developed symptoms while hospitalized. Cerebral ischemia complicated operative procedures in 12 patients, unsuccessful cardioversion in one and coronary angiography in another. Twelve patients had apparent cerebral embolism and 1...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.17.3.430

    authors: Kelley RE,Kovacs AG

    更新日期:1986-05-01 00:00:00

  • Thromboxane synthesis inhibitor in a beagle pup model of perinatal asphyxia.

    abstract::During perinatal asphyxia, cerebral blood flow is markedly reduced in the gray and white matter of the telencephalon. Since previous work has implicated prostaglandins in the control of blood flow, we tested the hypothesis that a thromboxane synthesis inhibitor would improve cerebral blood flow and blunt the metabolic...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.20.6.809

    authors: Ment LR,Stewart WB,Petroff OA,Duncan CC

    更新日期:1989-06-01 00:00:00

  • Monitoring of cerebral autoregulation in head-injured patients.

    abstract:BACKGROUND AND PURPOSE:Disturbed cerebral autoregulation has been reported to correlate with an unfavorable outcome after head injury. Using transcranial Doppler ultrasonography, we investigated whether hemodynamic responses to spontaneous variations of cerebral perfusion pressure (CPP) provide reliable information on ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.27.10.1829

    authors: Czosnyka M,Smielewski P,Kirkpatrick P,Menon DK,Pickard JD

    更新日期:1996-10-01 00:00:00

  • Occipital bone abnormality causing recurrent posterior circulation strokes.

    abstract::We report the case of a young man with recurrent posterior circulation strokes over the course of 6 years. Standard stroke evaluation was unremarkable until careful review of catheter angiogram and CT angiogram images revealed a bony protuberance from the occiput impinging on the left vertebral artery. Local vessel in...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.612176

    authors: Cronin CA,Aldrich EF,Kittner SJ

    更新日期:2011-05-01 00:00:00

  • There's no place like home : an evaluation of early supported discharge for stroke.

    abstract:BACKGROUND AND PURPOSE:Because stroke management is aimed at facilitating community reintegration, it would be logical that the sooner the patient can be discharged home, the sooner reintegration can commence. The purpose of this study was to determine the effectiveness of prompt discharge combined with home rehabilita...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.str.31.5.1016

    authors: Mayo NE,Wood-Dauphinee S,Côté R,Gayton D,Carlton J,Buttery J,Tamblyn R

    更新日期:2000-05-01 00:00:00

  • Guidelines for carotid endarterectomy. A multidisciplinary consensus statement from the ad hoc Committee, American Heart Association.

    abstract:BACKGROUND AND PURPOSE:Indications for carotid endarterectomy have engendered considerable debate among experts and have resulted in publication of retrospective reviews, natural history studies, audits of community practice, position papers, expert opinion statements, and finally prospective randomized trials. The Ame...

    journal_title:Stroke

    pub_type: 共识发展会议,指南,杂志文章,实务指引,评审

    doi:10.1161/01.str.26.1.188

    authors: Moore WS,Barnett HJ,Beebe HG,Bernstein EF,Brener BJ,Brott T,Caplan LR,Day A,Goldstone J,Hobson RW 2nd

    更新日期:1995-01-01 00:00:00

  • Level and value of circulating endothelial progenitor cells in patients after acute ischemic stroke.

    abstract:BACKGROUND AND PURPOSE:Endothelial progenitor cells (EPCs) migrate from bone marrow to systemic circulation in response to tissue ischemia where they differentiate into mature endothelial cells for angiogenesis in situ. This study tested the hypothesis that the level of circulating EPCs is substantially increased and p...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.489401

    authors: Yip HK,Chang LT,Chang WN,Lu CH,Liou CW,Lan MY,Liu JS,Youssef AA,Chang HW

    更新日期:2008-01-01 00:00:00

  • Disparities in Antihypertensive Prescribing After Stroke: Linked Data From the Australian Stroke Clinical Registry.

    abstract::Background and Purpose- Despite evidence to support the prescription of antihypertensive medications before hospital discharge to promote medication adherence and prevent recurrent events, many patients with stroke miss out on these medications at discharge. We aimed to examine patient, clinical, and system-level diff...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.026823

    authors: Dalli LL,Kim J,Thrift AG,Andrew NE,Lannin NA,Anderson CS,Grimley R,Katzenellenbogen JM,Boyd J,Lindley RI,Pollack M,Jude M,Durairaj R,Shah D,Cadilhac DA,Kilkenny MF

    更新日期:2019-12-01 00:00:00

  • Ionic concomitants of astroglial transformation to reactive species.

    abstract::Brain injury, including ischemia, changes normal astrocytes into reactive species that hypertrophy and begin to proliferate. Understanding the mechanisms that underlie these changes could lead to new abilities to promote regeneration and retard neural degeneration after ischemia. Because ionic changes occur after nonn...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:

    authors: Kraig RP,Jaeger CB

    更新日期:1990-11-01 00:00:00

  • Alberta Stroke Program Early CT Scale evaluation of multimodal computed tomography in predicting clinical outcomes of stroke patients treated with aspiration thrombectomy.

    abstract:BACKGROUND AND PURPOSE:Patient selection is crucial in the endovascular treatment of acute ischemic stroke patients. Baseline computed tomographic (CT) images, evaluated with the Alberta Stroke Program Early CT Scale (ASPECTS), are considered significant predictors of outcome. In this study, we evaluated CT images and ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.001068

    authors: Psychogios MN,Schramm P,Frölich AM,Kallenberg K,Wasser K,Reinhardt L,Kreusch AS,Jung K,Knauth M

    更新日期:2013-08-01 00:00:00

  • Magnetic Resonance Imaging Findings Related to Stroke Risk in Japanese Patients With Fabry Disease.

    abstract::Background and Purpose- Stroke is the most frequent severe clinical event in patients with Fabry disease. We aimed to evaluate the cerebral magnetic resonance imaging findings of patients with Fabry disease and assess their association with future stroke risk after enzyme replacement therapy (ERT) induction. Methods- ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.025528

    authors: Yagita Y,Sakai N,Miwa K,Ohara N,Tanaka M,Sakaguchi M,Kitagawa K,Mochizuki H

    更新日期:2019-09-01 00:00:00

  • Ten-year trends in stroke incidence and mortality in the FINMONICA Stroke Study.

    abstract:BACKGROUND AND PURPOSE:The trends in stroke incidence reported so far have not been entirely consistent, although declining trends in mortality from stroke have been reported from a number of studies around the world. This study aims to evaluate the 10-year trends (from 1983 through 1992) in incidence, attack rate, and...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.27.5.825

    authors: Tuomilehto J,Rastenyte D,Sivenius J,Sarti C,Immonen-Räihä P,Kaarsalo E,Kuulasmaa K,Narva EV,Salomaa V,Salmi K,Torppa J

    更新日期:1996-05-01 00:00:00

  • Potential of early [(18)F]-2-fluoro-2-deoxy-D-glucose positron emission tomography for identifying hypoperfusion and predicting fate of tissue in a rat embolic stroke model.

    abstract:BACKGROUND AND PURPOSE:Experimental stroke models are essential to study in vivo pathophysiological processes of focal cerebral ischemia. In this study, an embolic stroke model in rats was applied (1) to characterize early development of regional cerebral blood flow and metabolism with positron emission tomography (PET...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.111.624551

    authors: Walberer M,Backes H,Rueger MA,Neumaier B,Endepols H,Hoehn M,Fink GR,Schroeter M,Graf R

    更新日期:2012-01-01 00:00:00

  • Right-left propensity and lesion patterns between cardiogenic and aortogenic cerebral embolisms.

    abstract:BACKGROUND AND PURPOSE:Based on thrombus location and nature and anatomic features of aorta and cerebral arteries, we hypothesized that cardiogenic embolisms (CE) and aortogenic embolisms (AE) might have different right-left propensity and lesion patterns. METHODS:We retrospectively reviewed patients with acute ischem...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.111.616573

    authors: Kim HJ,Song JM,Kwon SU,Kim BJ,Kang DH,Song JK,Kim JS,Kang DW

    更新日期:2011-08-01 00:00:00

  • Incidence of transient ischemic attack in Rochester, Minnesota, 1985-1989.

    abstract:BACKGROUND AND PURPOSE:There is scant information available on the incidence of transient ischemic attack (TIA) in a defined population. This study defines incidence rates of first TIA and subtypes of TIA during 1985-1989 and compares the incidence to that obtained from a 1960-1972 cohort study. METHODS:Medical record...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.29.10.2109

    authors: Brown RD Jr,Petty GW,O'Fallon WM,Wiebers DO,Whisnant JP

    更新日期:1998-10-01 00:00:00

  • Analysis of reproducibility and sensitivity of atraumatic measurements of regional cerebral blood flow in cerebrovascular diseases.

    abstract::We tested the reproducibility of consecutive measurements of regional cerebral blood flow (rCBF) made in 13 areas of each hemisphere in patients with cerebrovascular diseases by the atraumatic 133Xe intravenous injection method. The data were analysed by a two-compartment model similar to that used in the Obrist inhal...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.14.1.82

    authors: Meric P,Luft A,Seylaz J,Mamo H

    更新日期:1983-01-01 00:00:00

  • Performance of carotid ultrasound in evaluating candidates for carotid endarterectomy is optimized by an approach based on clinical outcome rather than accuracy.

    abstract:BACKGROUND AND PURPOSE:The best method of selecting endarterectomy candidates for cerebral angiography is controversial. Carotid duplex ultrasound (CDUS) is widely used, but its performance varies across institutions. The clinical utility of CDUS could be improved with test criteria based on patient outcome rather than...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.27.6.1094

    authors: Wilterdink JL,Feldmann E,Easton JD,Ward R

    更新日期:1996-06-01 00:00:00

  • Beyond mismatch: evolving paradigms in imaging the ischemic penumbra with multimodal magnetic resonance imaging.

    abstract:BACKGROUND:The ability to quickly and efficiently identify the ischemic penumbra in the acute stroke clinical setting is an important goal for stroke researchers and clinicians. Early and accurate identification of potentially salvageable versus irreversibly infarcted brain tissue may enable selection of the most appro...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/01.STR.0000097608.38779.CC

    authors: Kidwell CS,Alger JR,Saver JL

    更新日期:2003-11-01 00:00:00

  • Pretreatment with U74006F improves neurologic outcome following complete cerebral ischemia in dogs.

    abstract::We examined the 21-aminosteroid U74006F, a potent inhibitor of lipid peroxidation, for potential neuroprotective effects in a canine model of complete cerebral ischemia. Two 1.5-mg/kg boluses were administered to six dogs, the first bolus 15 minutes prior to a 12-minute episode of complete cerebral ischemia and the se...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.22.7.902

    authors: Perkins WJ,Milde LN,Milde JH,Michenfelder JD

    更新日期:1991-07-01 00:00:00

  • Inclusion of stroke in cardiovascular risk prediction instruments: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

    abstract:BACKGROUND AND PURPOSE:Current US guideline statements regarding primary and secondary cardiovascular risk prediction and prevention use absolute risk estimates to identify patients who are at high risk for vascular disease events and who may benefit from specific preventive interventions. These guidelines do not expli...

    journal_title:Stroke

    pub_type: 杂志文章,实务指引

    doi:10.1161/STR.0b013e31825bcdac

    authors: Lackland DT,Elkind MS,D'Agostino R Sr,Dhamoon MS,Goff DC Jr,Higashida RT,McClure LA,Mitchell PH,Sacco RL,Sila CA,Smith SC Jr,Tanne D,Tirschwell DL,Touzé E,Wechsler LR,American Heart Association Stroke Council.,Council on

    更新日期:2012-07-01 00:00:00

  • Comparison of six depression rating scales in geriatric stroke patients.

    abstract::We compared three self-rating scales (the Geriatric Depression Scale, the Zung Scale, and the Center for Epidemiologic Studies Depression Scale) with three examiner-rating scales (the Hamilton Rating Scale, the Comprehensive Psychopathological Rating Scale-Depression, and the Cornell Scale), to see which was best for ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.20.9.1190

    authors: Agrell B,Dehlin O

    更新日期:1989-09-01 00:00:00

  • To treat or not to treat? Pilot survey for minor and rapidly improving stroke.

    abstract:BACKGROUND AND PURPOSE:Minor strokes and rapidly improving stroke symptoms are frequent exclusions for intravenous tissue-type plasminogen activator. We explored factors influencing tissue-type plasminogen activator treatment decision for minor strokes/rapidly improving stroke symptoms. METHODS:A pilot survey, includi...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.114.008290

    authors: Balucani C,Bianchi R,Feldmann E,Weedon J,Kolychev D,Levine SR

    更新日期:2015-03-01 00:00:00

  • Concomitant headache influences long-term prognosis after acute cerebral ischemia of noncardioembolic origin.

    abstract:BACKGROUND AND PURPOSE:Acute cerebral ischemia is frequently associated with headache. It is unknown whether concomitant headache reflects a partly different pathogenesis, and thus, may influence long-term prognosis after stroke. Here, we compared the long-term risk of recurrent vascular events in patients in whom a tr...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.002217

    authors: Maino A,Algra A,Koudstaal PJ,van Zwet EW,Ferrari MD,Wermer MJ,LiLAC Study Group.

    更新日期:2013-09-01 00:00:00

  • Ischemic Amnesia: Causes and Outcome.

    abstract:BACKGROUND AND PURPOSE:We aimed to describe the frequency and characteristics of acute ischemic stroke and transient ischemic attacks presenting predominantly with amnesia (ischemic amnesia) and to identify clinical clues for differentiating them from transient global amnesia (TGA). METHODS:We retrospectively analyzed...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.117.017420

    authors: Michel P,Beaud V,Eskandari A,Maeder P,Demonet JF,Eskioglou E

    更新日期:2017-08-01 00:00:00

  • Possible effect of DRGs on the classification of stroke: implications for epidemiological surveillance.

    abstract:BACKGROUND AND PURPOSE:Accurate data on the distribution of stroke subtypes are essential for understanding the forces driving recent morbidity and mortality trends. The introduction of diagnosis-related groups (DRGs) in the 1980s may have affected the distribution of stroke subtypes as defined by International Classif...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.32.7.1487

    authors: Derby CA,Lapane KL,Feldman HA,Carleton RA

    更新日期:2001-07-01 00:00:00

  • Intracranial Carotid Calcification on Cranial Computed Tomography: Visual Scoring Methods, Semiautomated Scores, and Volume Measurements in Patients With Stroke.

    abstract:BACKGROUND AND PURPOSE:Intracranial internal carotid artery calcification is associated with cerebrovascular risk factors and stroke, but few quantification methods are available. We tested the reliability of visual scoring, semiautomated Agatston score, and calcium volume measurement in patients with recent stroke. M...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.115.009716

    authors: Subedi D,Zishan US,Chappell F,Gregoriades ML,Sudlow C,Sellar R,Wardlaw J

    更新日期:2015-09-01 00:00:00

  • Distinguishing between stroke and mimic at the bedside: the brain attack study.

    abstract:BACKGROUND AND PURPOSE:The bedside clinical assessment of the patient with suspected stroke has not been well studied. Improving clinical skills may accelerate patient progress through the emergency department. We aimed to determine the frequency and nature of stroke mimics and to identify the key clinical features tha...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000204041.13466.4c

    authors: Hand PJ,Kwan J,Lindley RI,Dennis MS,Wardlaw JM

    更新日期:2006-03-01 00:00:00

  • Residual vessel length on magnetic resonance angiography identifies poor responders to alteplase in acute middle cerebral artery occlusion patients: exploratory analysis of the Japan Alteplase Clinical Trial II.

    abstract:BACKGROUND AND PURPOSE:It remains unknown whether the effects of 0.6 mg/kg alteplase differ with occlusion site of the middle cerebral artery (MCA). We therefore evaluated the effects of 0.6 mg/kg intravenous alteplase in patients with different sites of MCA occlusion. METHODS:An exploratory analysis was made of 57 pa...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究

    doi:10.1161/STROKEAHA.110.594333

    authors: Hirano T,Sasaki M,Mori E,Minematsu K,Nakagawara J,Yamaguchi T,Japan Alteplase Clinical Trial II Group.

    更新日期:2010-12-01 00:00:00