Revisiting Clinical Utility of Chest Radiography and Electrocardiogram to Determine Ischemic Stroke Subtypes: Special Reference on Vascular Pedicle Width and Maximal P-Wave Duration
| Autor: | Yuki Kamiya, Mitsuru Kawamura, Hiroo Ichikawa, Hidetomo Murakami, Natuko Iizuka, Masayuki Sugie |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Premature atrial contraction Radiography Electrocardiography Internal medicine D-dimer medicine P wave duration Humans Sinus rhythm Stroke Aged Vascular pedicle medicine.diagnostic_test business.industry Middle Aged medicine.disease Neurology Cardiology Female Neurology (clinical) business |
| Zdroj: | European neurology. 73(5-6) |
| ISSN: | 1421-9913 |
| Popis: | Backgrounds: It is often difficult to diagnose stroke subtypes at admission, particularly in sinus rhythm cases. Vascular pedicle width (VPW) on chest X-ray (CXR) and maximal P-wave duration (P-max) on electrocardiogram (ECG) are again realized as useful parameters reflecting intravascular volume and atrial conduction status, respectively. We investigated the utility of VPW and P-max as a tool for differentiating ischemic stroke subtypes. Methods: We studied 343 acute stroke patients showing sinus rhythm on admission. Dividing the patients into cardioembolic (CE) stroke (n = 57) and non-CE (n = 286) groups, we compared clinical backgrounds including VPW on CXR, and P-max in lead II and premature atrial contraction (PAC) on 12-leads ECG. Then, we investigated the independent factors for CE. Results: Independent factors associated with CE were VPW (≥59.3 mm) (p < 0.001; odds ratio (OR), 10.12; 95% confidence interval (CI), 4.13-24.8), P-max in lead II (≥120 ms) (p < 0.001; OR, 8.61; 95% CI, 3.96-18.7), PAC (p = 0.002; OR, 7.35; 95% CI, 2.14-25.3) and D-dimer level (≥1.11 µg/ml) (p = 0.016; OR, 2.57; 95% CI, 1.20-5.51). Conclusions: VPW, P-max, PAC and D-dimer are useful parameters for diagnosing CE stroke in patients with sinus rhythm at admission. |
| Databáze: | OpenAIRE |
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