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Cardio Embolic Strokes

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https://www.readbyqxmd.com/read/29650978/percutaneous-closure-of-left-atrial-appendage-significantly-affects-lipidome-metabolism
#1
G Yücel, M Behnes, C Barth, A Wenke, B Sartorius, K Mashayekhi, B Yazdani, T Bertsch, J Rusnak, A Saleh, U Hoffmann, C Fastner, S Lang, X Zhou, K Sattler, M Borggrefe, I Akin
Patients with non-valvular atrial fibrillation (AF) and a high risk for oral anticoagulation can be treated by percutaneous implantation of left atrial appendage occlusion devices (LAAC) to reduce the risk of cardio-embolic stroke. This study evaluates whether LAAC may influence lipid metabolism, which has never been investigated before. Patients with successful LAAC were included consecutively. Venous peripheral blood samples of patients were collected immediately before (T0, baseline) and 6 months after (T1, mid-term) LAAC...
April 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29327485/right-left-propensity-of-cardiogenic-cerebral-embolism-in-standard-versus-bovine-aortic-arch-variant
#2
Menachem Gold, Mojdeh Khamesi, Mangaiyarkkarasi Sivakumar, Vijaya Natarajan, Hooman Motahari, Nicholas Caputo
Left-hemispheric ischemic strokes are more frequent overall and often have a worse outcome than their right-hemispheric counterparts. We hypothesized that the right-left propensity of CE cerebral infarcts differs between patients with standard and bovine arch variants. We retrospectively identified all patients with acute stroke of the anterior circulation admitted to our primary stroke center between January 2011 and June 2017 who had moderate- to high-risk cardio-embolic sources according to the SSS-TOAST classification...
April 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29280256/heart-and-brain-interaction-in-patients-with-heart-failure-overview-and-proposal-for-a-taxonomy-a-position-paper-from-the-study-group-on-heart-and-brain-interaction-of-the-heart-failure-association
#3
REVIEW
Wolfram Doehner, Dilek Ural, Karl Georg Haeusler, Jelena Čelutkienė, Reinaldo Bestetti, Yuksel Cavusoglu, Marco A Peña-Duque, Duska Glavas, Massimo Iacoviello, Ulrich Laufs, Ricardo Marmol Alvear, Amam Mbakwem, Massimo F Piepoli, Stuart D Rosen, Georgios Tsivgoulis, Cristiana Vitale, M Birhan Yilmaz, Stefan D Anker, Gerasimos Filippatos, Petar Seferovic, Andrew J S Coats, Frank Ruschitzka
Heart failure (HF) is a complex clinical syndrome with multiple interactions between the failing myocardium and cerebral (dys-)functions. Bi-directional feedback interactions between the heart and the brain are inherent in the pathophysiology of HF: (i) the impaired cardiac function affects cerebral structure and functional capacity, and (ii) neuronal signals impact on the cardiovascular continuum. These interactions contribute to the symptomatic presentation of HF patients and affect many co-morbidities of HF...
February 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29250248/congenital-absence-of-left-atrial-appendage
#4
Tawseef Dar, Bharath Yarlagadda, Vijendra Swarup, Dhanunjaya Lakkireddy
Isolated absence of left atrial appendage is a very rare entity and is usually encountered as an incidental finding during routine imaging for other purposes. Lately, with increasing fund of knowledge about its potential role in cardio embolic phenomena, we have seen an increased trend in the use different techniques to exclude left atrial appendage from main left atrial chamber, in an effort to alleviate the stroke risk and therefore the need for long term anticoagulation. Clinical implications of absent left atrial appendage in such patients remains a mystery...
October 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29190627/gender-related-differences-and-short-term-outcome-of-stroke-results-from-a-hospital-based-registry-in-sub-saharan-africa
#5
Yacouba Njankouo Mapoure, Ngowo Lydia Eyambe, Anastase Tamdja Dzudie, Chia Mark Ayeah, Hamadou Ba, Romuald Hentchoya, Henry Namme Luma
BACKGROUND: Studies suggest that sex differences have an impact on patients with stroke, but existing data in Africa remain inconclusive about this inference. OBJECTIVES: To study sex differences in terms of the clinical profile and short-term outcome of stroke in the Douala General Hospital, Cameroon. METHODS: A hospital-based prospective cohort study was carried out in a tertiary care hospital over an 8-year period, which included all patients admitted for confirmed acute stroke...
2017: Neuroepidemiology
https://www.readbyqxmd.com/read/29117605/-new-oral-anticoagulants-noac-in-stroke-treatment
#6
Clemens Küpper, Lars Kellert, Steffen Tiedt, Frank Arne Wollenweber
Since 2011, new oral anticoagulants (NOAC) can be prescribed for prevention of cardio-embolic ischemic strokes in addition to vitamin K antagonists. NOAC are indicated in patients with non-valvular atrial fibrillation. Although its use is a matter of debate in Germany, the neurological and cardiological societies recommend the use of NOAC over and above vitamin K antagonists due to a better benefit-to-risk ratio attributed to it, especially because of the lower risk of intracranial hemorrhage in NOAC use. A specific antidote is commercially available for the direct thrombin inhibitor dabigatran only...
February 2018: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28966317/young-paradoxical-stroke-treated-successfully-with-mechanical-thrombectomy-using-solitaire-and-transcatheter-closure-of-patent-foramen-oval
#7
Qiang Fu, Xiaobin Guo, Dapeng Mo, Buxing Chen
Paradoxical embolization is the mechanism for patent foramen ovale (PFO)-associated cryptogenic stroke and transcatheter closure of PFO may prevent recurrent ischemic stroke. Mechanical thrombectomy is promising to treat acute ischemic stroke due to high rates of reperfusion and reduced intracranial hemorrhage complications. We report the case of a 27-year-old woman with a massive cerebral infarction but no evidence for any atherosclerosis, who received an urgent mechanical thrombectomy with a Solitaire device...
October 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28906205/preventing-cognitive-decline-and-dementia-from-cerebral-small-vessel-disease-the-laci-1-trial-protocol-and-statistical-analysis-plan-of-a-phase-iia-dose-escalation-trial-testing-tolerability-safety-and-effect-on-intermediary-endpoints-of-isosorbide-mononitrate
#8
Gordon W Blair, Jason P Appleton, Zhe Kang Law, Fergus Doubal, Katie Flaherty, Richard Dooley, Kirsten Shuler, Carla Richardson, Iona Hamilton, Yulu Shi, Michael Stringer, Julia Boyd, Michael J Thrippleton, Nikola Sprigg, Philip M Bath, Joanna M Wardlaw
Rationale The pathophysiology of most lacunar stroke, a form of small vessel disease, is thought to differ from large artery atherothrombo- or cardio-embolic stroke. Licensed drugs, isosorbide mononitrate and cilostazol, have promising mechanisms of action to support their testing to prevent stroke recurrence, cognitive impairment, or radiological progression after lacunar stroke. Aim LACI-1 will assess the tolerability, safety, and efficacy, by dose, of isosorbide mononitrate and cilostazol, alone and in combination, in patients with ischemic lacunar stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28870596/common-and-specific-risk-factors-for-ischemic-stroke-in-elderly-differences-based-on-type-of-ischemic-stroke-and-aging
#9
Sayato Fukui, Ryoko Imazeki, Yu Amano, Yousuke Kudo, Kazumitsu Amari, Masahiro Yamamoto, Kikue Todoroki, Yoshimori Ikeya, Takashi Okazaki, Noriharu Yanagimachi, Toru Shizuma, Naoto Fukuyama, Ken Johkura, Hidezo Mori
BACKGROUND: The risk factors among the types of ischemic stroke (atherothrombotic cerebral infarction: ATI, cardio-embolic infarction: CEI, lacunar infarction: LI) in aged stroke patients have rarely been compared to each other. METHODS: We compared the clinical parameters of 300 elderly patients with ischemic stroke, age 65-98years, to 100 age-matched control patients. RESULTS: Comparison by parametric test and logistic regression analysis between all 300 and 100 control patients showed higher systolic and diastolic blood pressures (p<0...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28861455/baseline-characteristics-and-event-rates-among-anticoagulated-patients-with-atrial-fibrillation-in-practice-and-pivotal-noac-trials
#10
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
The data report details the baseline characteristics and observed outcomes among patients included in a large US administrative claims database (Optum Labs Data Warehouse) and those enrolled in the pivotal phase III clinical trials examining apixaban, dabigratan, edoxaban and rivaroxaban versus warfarin for the prevention of cardio embolism (Granger et al., 2011; Cannolly et al., 2009; Patel et al., 2011; Giugliano et al., 2013) [1], [2], [3], [4]. These data are to be interpreted in the context of the linked publication (Noseworthy et al...
October 2017: Data in Brief
https://www.readbyqxmd.com/read/28818261/contemporary-medical-therapies-of-atherosclerotic-carotid-artery-disease
#11
REVIEW
Suk F Cheng, Martin M Brown
Contemporary medical therapy consists of identification and treatment of all patient-modifiable vascular risk factors. Specific atherosclerotic disease therapies are designed to reduce the risk of thrombosis, and the disease progression in order to reduce the risk of future cardiovascular events. Contemporary medical management emphasizes the need to support the patient in achieving lifestyle modifications and to adjust medication to achieve individualized target values for specific quantifiable risk factors...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28684376/the-association-between-arterial-stiffness-initial-stroke-severity-and-3-week-outcomes-in-patients-with-ischemic-stroke
#12
Emma Ormerod, Khalid Ali, James Cameron, Muzaffar Malik, Richard Lee, Spas Getov, Chakravarthi Rajkumar
OBJECTIVES: Vascular compliance is emerging as a useful cardiovascular risk factor. The aim of this study was to investigate the association between arterial stiffness and stroke severity at presentation and 3 weeks. METHODS: Forty two patients with acute ischemic stroke (55% male, mean age 71 years) were recruited over 15-months. Stroke subtypes were classified into lacunar circulation infarct (LACI), partial anterior circulation infarct (PACI), and posterior circulation infarct (POCI)...
November 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28657348/comparing-the-economic-burden-of-ischemic-stroke-patients-with-and-without-atrial-fibrillation-a-retrospective-study-in-beijing-china
#13
Liankui Wen, Jingjing Wu, Lin Feng, Li Yang, Feng Qian
BACKGROUND: Little is known about the economic burden for ischemic stroke (IS) patients with atrial fibrillation (AF) in China. AIM: We aimed to compare the economic burden of treatment-related costs in IS patients with AF vs. without AF in China. METHODS: This retrospective analysis used economic burden data from the Beijing urban health insurance database. Using a random sampling method, 10% of the patients diagnosed with IS from 1 January through 31 December 2012 were enrolled...
October 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28436306/cardiac-magnetic-resonance-imaging-has-limited-additional-yield-in-cryptogenic-stroke-evaluation-after-transesophageal-echocardiography
#14
Ava L Liberman, Rizwan E Kalani, Jessie Aw-Zoretic, Matthew Sondag, Vistasp J Daruwalla, Sumeet S Mitter, Richard Bernstein, Jeremy D Collins, Shyam Prabhakaran
Background The use of cardiac magnetic resonance imaging is increasing, but its role in the diagnostic work-up following ischemic stroke has received limited study. We aimed to explore the added yield of cardiac magnetic resonance imaging to identify cardio-aortic sources not detected by transesophageal echocardiography among patients with cryptogenic stroke. Methods A retrospective single-center cohort study was performed from 01 January 2009 to 01 March 2013. Consecutive patients who had both a stroke protocol cardiac magnetic resonance imaging and a transesophageal echocardiography preformed during a single hospitalization were included...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28427984/effect-of-baseline-characteristics-on-the-outcome-of-stent-retriever-based-thrombectomy-in-acute-basilar-artery-occlusions-a-single-center-experience-and-pooled-data-analysis
#15
REVIEW
Wan-Ling Wen, Zi-Fu Li, Yong-Wei Zhang, Peng-Fei Yang, Keith Simfukwe, Yi-Bin Fang, Tian-Yi Zhang, Ben-Qiang Deng, Bo Hong, Jian-Min Liu, Qing-Hai Huang
OBJECTIVES: To explore the association of baseline characteristics and the outcome of patients with acute basilar artery occlusion (BAO) after stent retriever-based thrombectomy (SRT). METHODS: Clinical and imaging information of consecutive SRT-treated patients with BAO from a comprehensive stroke center and up-to-date literature were reviewed respectively. The impact of baseline variables toward favorable outcome was evaluated using subgroup analysis and odds ratio (OR) extracted from published data together with single-center records using pooled analysis...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28364691/incidence-of-seizures-following-initial-ischemic-stroke-in-a-community-based-cohort-the-framingham-heart-study
#16
Maria Stefanidou, Rohit R Das, Alexa S Beiser, Banu Sundar, Margaret Kelly-Hayes, Carlos S Kase, Orrin Devinsky, Sudha Seshadri, Daniel Friedman
PURPOSE: We examined the incidence of seizures following ischemic stroke in a community-based sample. METHODS: All subjects with incident ischemic strokes in the Framingham Original and Offspring cohorts between 1982 and 2003 were identified and followed for up to 20 years to determine incidence of seizures. Seizure-type was based on the 2010 International League Against Epilepsy (ILAE) classification. Disability was stratified into mild/none, moderate and severe, based on post-stroke neurological deficit documentation according to the Framingham Heart Study (FHS) protocol and functional status was determined using the Barthel Index...
April 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28302243/coexistent-mitral-stenosis-and-multiple-sclerosis-an-unprecedented-case
#17
Ali Zohair Nomani, Irfan Ullah Khatak, Mansoor Iqbal, Haris Majid Rajput, Sumaira Nabi
Mitral stenosis is a valvular heart disease characterised by narrowing of mitral orifice. It can lead to a dilated left atrium with atrial fibrillation culminating into thrombus formation. Patients with mitral stenosis, presenting with stroke-like episodes, most likely experience cardio-embolic phenomenon; but unusual and unprecedented associations do occur. Reported association of cardiac MS with demyelinating CNS MS has never been proven; but authors have speculated theories based on case reports and series...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28294644/electrocardiogram-changes-and-atrial-arrhythmias-in-individuals-carrying-sodium-channel-scn5a-d1275n-mutation
#18
Sari U M Vanninen, Kjell Nikus, Katriina Aalto-Setälä
INTRODUCTION: The cardiac sodium channel SCN5A regulates atrioventricular and ventricular depolarization as well as cardiac conduction. Patients with cardiac electrical abnormalities have an increased risk of sudden cardiac death (SCD) and cardio-embolic stroke. Optimal management of cardiac disease includes the understanding of association between the causative mutations and the clinical phenotype. A 12-lead electrocardiogram (ECG) is an easy and inexpensive tool for finding risk patients...
April 17, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28198520/twelve-month-follow-up-of-left-atrial-appendage-occlusion-with-amplatzer-amulet
#19
Caroline Kleinecke, Jai-Wun Park, Martin Gödde, Konstantin Zintl, Steffen Schnupp, Johannes Brachmann
BACKGROUND: The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second gen-eration Amplatzer device for left atrial appendage (LAA) occlusion (LAAO) for stroke prophylaxis in patients with atrial fibrillation. This research sought to assess the clinical performance of the Amplatzer Amulet device and in follow up for 12 months. METHODS: In this single-center registry patients with atrial fibrillation and contraindication to oral anticoagulation underwent LAAO with the Amplatzer Amulet device...
2017: Cardiology Journal
https://www.readbyqxmd.com/read/28128037/secondary-prevention-of-childhood-arterial-ischemic-stroke
#20
Stéphane Darteyre, Cyrille Renaud, Joel Fluss, Silvy Laporte, Laurent Bertoletti, Stéphane Chabrier
This study aimed to know how frontline physicians in France, Belgium, and Switzerland implement guidelines regarding the secondary prevention of childhood arterial ischemic stroke and to introduce physicians' point of view on a clinical trial assessing the efficacy of aspirin as a preventive strategy. The authors conducted an online survey directed at specialists throughout dedicated networks and used a mixed method for data analysis. Overall, 63 physicians responded, and 88% prescribe aspirin when sickle cell disease, cardio-embolic stroke, and dissection of cervical arteries are excluded...
April 2017: Journal of Child Neurology
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