Different infarction patterns in patients with aortic atheroma compared to those with cardioembolism or large artery atherosclerosis
- 주제(키워드) Ischemic stroke , Aortic arch atheroma , Diffusion-weighted imaging , Transesophageal echocardiography
- 주제(기타) Clinical Neurology
- 설명문(일반) [Kim, Seung Woo; Kim, Young Dae; Chung, Seok Jong; Song, Dongbeom; Heo, Ji Hoe; Nam, Hyo Suk] Yonsei Univ, Dept Neurol, Coll Med, Seoul, South Korea; [Chang, Hyuk-Jae; Hong, Geu-Ru; Shim, Chi Young] Yonsei Univ, Dept Cardiol, Coll Med, Seoul, South Korea; [Hong, Jin Yong] Yonsei Univ, Dept Neurol, Wonju Coll Med, Wonju, South Korea; [Song, Tae-Jin] Ewha Womans Univ, Dept Neurol, Sch Med, Seoul, South Korea; [Bang, Oh Young] Sungkyunkwan Univ, Dept Neurol, Sch Med, Seoul, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 SPRINGER HEIDELBERG
- 발행년도 2018
- URI http://www.dcollection.net/handler/ewha/000000149959
- 본문언어 영어
- Published As http://dx.doi.org/10.1007/s00415-017-8685-7
초록/요약
Aortic atheroma is a known cause of ischemic stroke. However, it is unclear whether ischemic stroke is caused by emboli from aortic atheroma or by accompanying atherosclerosis. In this study, we evaluated lesion patterns of patients with complex aortic plaque (CAP) to assume the underlying pathophysiology. Acute ischemic stroke patients who underwent transesophageal echocardiography were included. CAP was defined as a plaque in the proximal aorta ae<yen> 4 mm thick or with a mobile component. The diffusion-weighted imaging lesion patterns of patients with CAP were compared to those with large arterial atherosclerosis (LAA) or cardioembolism (CE). A total of 64 CAP patients, 127 LAA patients, and 80 CE patients were included. Small cortical pattern was more common in the CAP group (45.3%) than in the LAA (7.9%, p < 0.001) or the CE group (23.8%, p = 0.018). A large cortical pattern was more common in the CE group than in the CAP group (p < 0.001), whereas subcortical only pattern tended to be more common in the CAP group than in the CE group (p = 0.057). In multinominal analysis, the CAP group was more likely to have a small cortical lesion than the LAA group [odds ratio (OR) 14.63; 95% confidence interval (CI) 4.67-45.85] or the CE (OR 3.69, 95% CI 1.19-11.39) group. In conclusion, patients with CAP frequently had small cortical lesions or subcortical single lesion. These findings imply that ischemic stroke in aortic atheroma patients is associated with either small emboli or small artery disease.
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