Atrial Cardiopathy Biomarkers and MRI-Based Infarct Patterns in Patients with Embolic Strokes of Undetermined Source
| Autor: | Dae-Hyun Kim, Yoon-Kyung Lee, Byeol-A Yoon, Byung-Cheol Gwak, Jae-Kwan Cha |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Brain Infarction
Male medicine.medical_specialty Time Factors medicine.drug_class Logistic regression Lesion 03 medical and health sciences 0302 clinical medicine Left atrial Predictive Value of Tests Internal medicine Natriuretic Peptide Brain medicine Natriuretic peptide Humans In patient cardiovascular diseases Registries Aged Retrospective Studies Aged 80 and over Embolic Stroke business.industry Rehabilitation Odds ratio Atrial Remodeling Middle Aged Confidence interval Peptide Fragments Diffusion Magnetic Resonance Imaging Echocardiography Infarct volume Cardiology Surgery Atrial Function Left Female Neurology (clinical) medicine.symptom Cardiology and Cardiovascular Medicine business Cardiomyopathies 030217 neurology & neurosurgery Biomarkers |
| Zdroj: | Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 30(8) |
| ISSN: | 1532-8511 |
| Popis: | Objectives The study aimed to investigate whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration and/or left atrial volume index (LAVI), as atrial cardiopathy biomarkers, were associated with infarct patterns on diffusion-weighted imaging in patients with embolic strokes of undetermined source (ESUS). Materials and Method We retrospectively evaluated patient with ESUS from our stroke registry between January 2018 and November 2019. Cut-off values for atrial cardiopathy biomarkers were defined as >250 pg/mL for NT-proBNP and >34 mL/m2 for LAVI. Eligible patients were then assigned to 3 groups and infarct patterns were compared according to their atrial cardiopathy markers: Group 1 (no atrial cardiopathy markers), Group 2 (one marker), and Group 3 (both markers). Results Among 194 eligible patients with ESUS (76 women; mean age, 69.2 years), simultaneous increases of NT-proBNP concentration and LAVI were identified in 39 (20.1%). Group 3 had a significantly larger infarct volume, relative to Group 1 and Group 2 (P=0.043) Multivariable logistic regression analyses revealed that these patients (Group 3) were significantly more likely to have multi-territorial infarcts (adjusted odds ratio [aOR]: 3.03, 95% confidence interval [CI]: 1.05-8.72; P=0.04), a maximal lesion diameter >15mm (aOR: 4.51, 95% CI: 1.70-11.93; P=0.001), and large cortical infarctions (aOR: 4.17, 95% CI: 1.75-9.96; P=0.001). Conclusion We found that simultaneously increased values for NT-proBNP concentration and LAVI were independently associated with multi-territorial and large cortical infarct patterns in patients with ESUS. These findings suggest that NT-proBNP and LAVI may be useful biomarkers for identifying cardioembolic subtypes and guiding treatment selection in patients with ESUS. |
| Databáze: | OpenAIRE |
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