Stroke in right dorsal anterior insular cortex Is related to myocardial injury
| Autor: | Jan F. Scheitz, Jochen B. Fiebach, Kathrin Werner, Christian H. Nolte, Matthias Endres, Sophie K. Piper, Kersten Villringer, Thomas Krause, Karl Georg Haeusler |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.diagnostic_test
business.industry Confounding Magnetic resonance imaging Coronary ischemia 030204 cardiovascular system & hematology medicine.disease Insular cortex computer.software_genre Lesion 03 medical and health sciences 0302 clinical medicine Neurology Functional neuroimaging Voxel Anesthesia medicine Neurology (clinical) medicine.symptom business Stroke computer 030217 neurology & neurosurgery |
| Zdroj: | Annals of Neurology. 81:502-511 |
| ISSN: | 0364-5134 |
| Popis: | Objective Elevated levels of cardiac troponin, and especially their relative changes over time, indicate acute myocardial injury. They are also frequently observed after acute ischemic stroke (AIS), indicating poor functional outcome and increased mortality. However, recent evidence showed that, in most AIS patients, myocardial injury is not caused by coronary ischemia. Instead, stroke lesion location has been suggested to precipitate myocardial injury. Methods Voxel-based lesion-symptom mapping (VLSM) was used in 299 patients who had a magnetic resonance imaging–confirmed acute ischemic stroke within the anterior circulation and a high-sensitivity cardiac troponin T (hs-cTnT) acquired on the day of admission. Of these, 228 had a second troponin measurement during the acute phase. The absolute hs-cTnT levels above the 99th percentile of a healthy reference population (≥14ng/l) as well as their relative temporal changes were used as continuous variables of interest in the VLSM model, including a multiple regression analysis adjusted for confounding variables. Results The anterior insular cortex of the right hemisphere, in particular its dorsal subregion, was significantly associated with the relative temporal changes of hs-cTnT (p |
| Databáze: | OpenAIRE |
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