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Cardioembolic stroke

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https://www.readbyqxmd.com/read/28224399/can-neuroimaging-differentiate-pfo-and-af-related-cardioembolic-stroke-from-the-other-embolic-sources-clinical-radiological-correlation-on-a-retrospective-study
#1
Alessandro Stecco, Martina Quagliozzi, Eleonora Soligo, Andrea Naldi, Alessia Cassarà, Lorenzo Coppo, Roberta Rosso, Angelo Sante Bongo, Paola Amatuzzo, Francesco Buemi, Elena Guenzi, Alessandro Carriero
PURPOSE: The aim of this retrospective study was to map the specific ischemic lesion patterns of distribution in patent foramen ovale-related stroke (PFO-stroke) and atrial fibrillation-related stroke (AF-stroke) in patients with idiopatic ischemic stroke. MATERIALS AND METHODS: 750 ischaemic strokes were screened on basis of diagnostic imaging and tests: patients with known causes were excluded. 171 patients with unknown cause were selected and divided in two groups: AF-stroke (43 patients) and PFO-stroke (128 patients)...
February 21, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28212133/potential-uselessness-and-futility-of-left-atrial-appendage-occlusion-and-patent-foramen-ovale-closure-in-cardioembolic-stroke
#2
Gian L Nicolosi
International guidelines indicate that interventional closure of left atrial appendage and patent foramen ovale may be considered in selected patients for stroke prevention. These procedures appear, however, from the published literature, at high risk of uselessness and futility in the single case, if not even capable to induce harm and adverse events. In fact, all reported systematic reviews and meta-analyses have not shown in a convincing manner the superiority of these procedures in stroke prevention, taking into account the occurrence of possible complications also, as compared with alternative medical treatment...
February 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28209460/pharmacologic-cardioversion-with-intravenous-amiodarone-is-likely-safe-in-neurocritically-ill-patients
#3
Michael Su, David Seki, Asma M Moheet
Neurological injury is often associated with cardiac abnormalities, including electrophysiological issues. Cardioversion of acute atrial fibrillation (<48h' duration) without anticoagulation carries about a 0.7% risk of thromboembolism. There is limited data on managing acute atrial fibrillation specifically in the neuroscience intensive care unit (NSICU) setting. We sought to determine the safety of using intravenous (IV) amiodarone for restoring sinus rhythm in patients with presumed new onset atrial or ventricular tachycardia after neurological injury...
February 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28208130/factors-related-to-cardioembolism-as-major-predictors-of-poor-survival-after-first-ever-middle-cerebral-artery-stroke-treated-with-thrombolysis
#4
Renata Dal-Prá Ducci, Marcos Christiano Lange, Viviane de Hiroki Flumignan Zétola, Tatjana Rundek
BACKGROUND AND PURPOSE: Prognostic factors related to mortality rates after stroke have been reported; however, most studies included different treatments and did not focus solely on ischemic stroke. The study aimed to report the short- and long-term survival and predictors of death in patients with first-ever ischemic stroke in the middle cerebral artery (MCA) territory, submitted to intravenous thrombolysis (IVT). METHODS: A prospective observational cohort study of patients with first-ever ischemic stroke in the MCA territory treated with IVT from March 2010 to February 2015 was conducted, and patients were followed up until May 2015...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28199366/micrornas-regulating-cluster-of-differentiation-46-cd46-in-cardioembolic-and-non-cardioembolic-stroke
#5
Jun Rong Tan, Kay Sin Tan, Fung Lin Yong, Arunmozhiarasi Armugam, Chee Woon Wang, Kandiah Jeyaseelan, Peter Tsun-Hon Wong
Ischemic stroke is a major cause of mortality and morbidity globally. Among the ischemic stroke subtypes, cardioembolic stroke is with poor functional outcome (Modified Rankin score ≥ 2). Early diagnosis of cardioembolic stroke will prove beneficial. This study examined the microRNAs targeting cluster of differentiation 46 (CD46), a potential biomarker for cardioembolic stroke. CD46 mRNA level was shown to be differentially expressed (p < 0.001) between cardioembolic stroke (median = 1.32) and non-cardioembolic stroke subtypes (large artery stroke median = 5...
2017: PloS One
https://www.readbyqxmd.com/read/28195503/pro-atrial-natriuretic-peptide-and-prediction-of-atrial-fibrillation-and-stroke-the-malm%C3%A3-preventive-project
#6
John Berntsson, J Gustav Smith, Peter M Nilsson, Bo Hedblad, Olle Melander, Gunnar Engström
Background The increasing prevalence of atrial fibrillation and novel therapeutic tools to prevent cardioembolic stroke has increased the need for risk markers. Objectives This study explored the relationship between the midregional sequence of pro-atrial natriuretic peptide (MR-proANP) levels with the risk of atrial fibrillation and stroke, and whether measurement of MR-proANP improves the prediction of these outcomes. Methods MR-proANP was measured in fasting blood samples of 5130 subjects (69% men, mean age 69...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28190604/the-fate-of-acute-lacunar-lesions-in-terms-of-shape-and-size
#7
Ki Jeong Lee, Hyeyoung Jung, Yoon-Sang Oh, Eun Ye Lim, A-Hyun Cho
BACKGROUND: The description of lacunar infarcts on imaging is widely variable. In particular, there are fewer agreements on lacunar lesion size and the presence of cavitation. In this regard, we investigated the changes in size and shape of acute ischemic lesion that is possibly considered as small vessel occlusion on long-term follow-up. METHODS: Patients with acute single subcortical ischemic lesion on penetrating arterial territories and without definite cause of cardioembolism and large vessel disease were included...
February 9, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28188400/-juvenile-stroke-what-is-important
#8
M Fischer, B Eckert, J Röther
Stroke in young adults is a diagnostic and therapeutic challenge for all persons involved. Approximately 15% of ischemic strokes occur in young adults. Lack of awareness of the symptoms in emergency departments often results in delayed diagnosis and access to specific therapeutic options, such as revascularization. The causes are often heterogeneous and necessitate specific investigations. The etiology of juvenile stroke includes drug abuse, vasculitis and arteriopathies, such as reversible vasoconstriction syndrome and posterior reversible encephalopathy syndrome, although the prevalence of classical vascular risk factors is high...
February 10, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28178140/utility-of-duranta-a-wireless-patch-type-electrocardiographic-monitoring-system-developed-in-japan-in-detecting-covert-atrial-fibrillation-in-patients-with-cryptogenic-stroke-a-case-report
#9
Hisanao Akiyama, Saki Nukui, Takashi Araga, Masashi Hoshino, Keita Tanaka, Satoru Kashima, Rie Sasaki, Kenji Uchino, Yasuhiro Hasegawa
RATIONALE: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28170136/intracranial-posterior-circulation-large-artery-thrombi-visualized-using-susceptibility-weighted-mri
#10
Naidong Wang, Qimin Hu, Qiaoshu Wang, Jinglong Zhao, Nikita Dedhia, Louis R Caplan
PURPOSE: To identify thrombi in patients with posterior circulation large artery occlusion using susceptibility-weighted magnetic resonance imaging (MRI). METHODS: All patients hospitalized with intracranial posterior circulation occlusion from January 2003 to September 2013 were included. MRI and computed tomography angiography were reviewed to determine the presence of arterial occlusion and identify thrombi. Eighty-one patients were analyzed to investigate susceptibility vessel sign (SVS) that was identified as blooming artifact (BA) on T2*-weighted gradient echo imaging...
February 7, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28169410/-long-term-effect-of-policosanol-on-the-functional-recovery-of-non-cardioembolic-ischemic-stroke-patients-a-one-year-study
#11
J Sanchez, J Illnait, R Mas, S Mendoza, L Fernandez, M Mesa, H Vega, J Fernandez, P Reyes, D Ruiz
INTRODUCTION: Stroke is a leading cause of mortality and disability. Policosanol has been effective in brain ischemia models. The aim of this study is to investigate whether policosanol, added to aspirin therapy within 30 days of stroke onset, is better than placebo + aspirine for the long-term recovery of non-cardioembolic ischemic stroke subjects. PATIENTS AND METHODS: Randomized, double-blind, placebo-controlled study. Eighty patients (mean age: 69 years) within 30 days of onset, with a modified Rankin Scale score (mRS) 2 to 4, were included...
February 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28158211/major-vessel-occlusion-may-predict-subtherapeutic-anticoagulation-intensity-and-feasibility-of-administration-of-intravenous-thrombolytics
#12
Jun Young Chang, Seunguk Jung, Hyun Park, Moon-Ku Han
OBJECTIVE: We investigated the association between the presence of major vessel occlusion (MVO) and the intensity of the International Normalized Ratio (INR) in cardioembolic high-risk patients taking warfarin. We also evaluated whether the presence of MVO could predict the subtherapeutic range of INR ≤1.7 ensuring safe administration of intravenous thrombolytics. METHODS: The medical records of 177 cardioembolic stroke patients who were taking warfarin between April, 2008 and March, 2015 were retrospectively analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28157747/cardioembolic-stroke
#13
Cumara B O'Carroll, Kevin M Barrett
PURPOSE OF REVIEW: Cardioembolic stroke is common and disproportionately more disabling than nonembolic mechanisms of stroke. Its incidence is expected to rise because of the age-related incidence of atrial fibrillation and an aging population. This article summarizes the different causes of cardioembolism and outlines current management guidelines. RECENT FINDINGS: Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28154101/cardioembolic-stroke
#14
Hooman Kamel, Jeff S Healey
Cardiac embolism accounts for an increasing proportion of ischemic strokes and might multiply several-fold during the next decades. However, research points to several potential strategies to stem this expected rise in cardioembolic stroke. First, although one-third of strokes are of unclear cause, it is increasingly accepted that many of these cryptogenic strokes arise from a distant embolism rather than in situ cerebrovascular disease, leading to the recent formulation of embolic stroke of undetermined source as a distinct target for investigation...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28151434/detection-of-atrial-fibrillation-episodes-using-a-wristband-device
#15
Valentina D A Corino, Rita Laureanti, Lorenzo Ferranti, Giorgio Scarpini, Federico Lombardi, Luca Mainardi
Undiagnosed atrial fibrillation (AF) patients are at high risk of cardioembolic stroke or other complications. The aim of this study was to analyze the blood volume pulse (BVP) signals obtained from a wristband device and develop an algorithm for discriminating AF from normal sinus rhythm (NSR) or from other arrhythmias (ARR). Thirty patients with AF, 9 with ARR and 31 in NSR were included in the study. The recordings were obtained at rest from Empatica E4 wristband device and lasted 10 minutes. The analysis, on a two-minute segment, included spectral, variability and irregularity analysis performed on the inter-diastolic interval series, and similarity analysis performed on the BVP signal...
February 2, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28149079/intravenous-thrombolysis-for-acute-ischemic-stroke-review-of-97-patients
#16
Anish Mehta, Rohan Mahale, Kiran Buddaraju, Anas Majeed, Suryanarayana Sharma, Mahendra Javali, Purushottam Acharya, Rangasetty Srinivasa
BACKGROUND: Intravenous thrombolysis (IVT) has now become a standard treatment in eligible patients with acute ischemic stroke (AIS) who present within 4.5 h of symptom onset. OBJECTIVE: To determine the usefulness of IVT and the subset of patients who will benefit from IVT in AIS within 4.5 h. MATERIALS AND METHODS: Patients with AIS within 4.5 h of symptom onset who underwent IVT were studied prospectively. The study period was from October 2011 to October 2015...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28148612/cardioembolic-stroke-a-case-study
#17
Lisa A Babkair
Cardioembolic stroke is a critical health condition that requires immediate intervention. Cardiac emboli are the most common type of embolism and account for 14% to 30% of all ischemic strokes. Atrial fibrillation is the most common cause of cardioembolic strokes, and its prevalence increases substantially with age. Other factors that increase the risk for cardioembolic stroke include hypertension, diabetes mellitus, hyperlipidemia, cardiac disease, and lifestyle choices. General supportive care and treatment of the acute phase and subsequent complications should be started immediately...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28131222/clopidogrel-and-ischemic-stroke-outcomes-by-smoking-status-smoker-s-paradox
#18
Qian Zhang, Yuan Wang, Haiqing Song, Chengbei Hou, Qingyu Cao, Kai Dong, Xiaoqin Huang, Wuwei Feng, Bruce Ovbiagele, Moli Wang, Xunming Ji
BACKGROUND AND PURPOSE: Active smokers with myocardial infarction were shown to have enhanced benefit with clopidogrel compared with aspirin. Whether this "paradox" exists in ischemic stroke patients is unknown. We aimed to investigate whether smoking status has a differential impact on the efficacy of clopidogrel vs. aspirin in patients with non-cardioembolic strokes. METHODS: This single-center study retrospectively assessed 1792 non-cardioembolic ischemic stroke patients discharged from January 2013 to October 2014, and followed for 12months...
February 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28123058/procalcitonin-and-midregional-proatrial-natriuretic-peptide-as-biomarkers-of-subclinical-cerebrovascular-damage-the-northern-manhattan-study
#19
Mira Katan, Yeseon Moon, Arnold von Eckardstein, Kathartina Spanaus, Janet DeRosa, Jose Gutierrez, Charles DeCarli, Clinton Wright, Ralph Sacco, Mitchell Elkind
BACKGROUND AND PURPOSE: Chronic infections and cardiac dysfunction are risk factors for stroke. We hypothesized that blood biomarkers of infection (procalcitonin) and cardiac dysfunction (midregional proatrial natriuretic peptide [MR-proANP]), previously associated with small vessel stroke and cardioembolic stroke are also associated with subclinical cerebrovascular damage, including silent brain infarcts and white matter hyperintensity volume. METHODS: The NOMAS (Northern Manhattan Study) was designed to assess risk factors for incident vascular disease in a multiethnic cohort...
January 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28117601/blood-markers-of-inflammation-and-endothelial-dysfunction-in-cardioembolic-stroke-systematic-review-and-meta-analysis
#20
Benedetta Piccardi, Dolors Giralt, Alejandro Bustamante, Victor Llombart, Teresa García-Berrocoso, Domenico Inzitari, Joan Montaner
CONTEXT: various processes including inflammation and endothelial dysfunction have been implicated in the pathogenesis of cardioembolic (CE) strokes. OBJECTIVE: to review the evidence and investigate the association between immune-inflammatory biomarkers and CE strokes versus other stroke subtypes. METHODS: we systematically reviewed the literature (sources: MEDLINE, web-based register http://stroke-biomarkers.com , reference lists) with quality assessment and meta-analysis of selected articles...
January 24, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
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