非瓣膜性心房颤动患者残留左心房血栓的移动性与中风严重程度之间的关系

IF 1.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Nippon Medical School Pub Date : 2024-01-01 DOI:10.1272/jnms.JNMS.2024_91-311

Yuji Kato, Takeshi Hayashi, Shintaro Nakano, Takahide Arai, Shinako Fujiwara, Kaito Watanabe, Kiichiro Oryu, Ryutaro Kimura, Noriko Arai, Toru Nakagami, Ichiro Deguchi, Shinichi Takahashi, Satoshi Suda

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引用次数: 0

摘要

背景：移动性与非移动性残留左心房血栓（LAT）相关缺血性卒中的特征差异尚不清楚。我们研究了经胸超声心动图检测到的 LAT 移动性是否与中风的临床特征相关：本研究连续纳入了 20 名因急性缺血性脑卒中入院接受治疗的非瓣膜性心房颤动患者，这些患者在接受经胸超声心动图检查时被发现患有 LAT。这些患者被分为两组：移动性 LAT（M 组）和非移动性 LAT（N 组）。对临床、神经放射学和超声心动图变量进行了评估：结果：11 名患者（M 组）的 LAT 可移动，9 名患者（N 组）的 LAT 不可移动。入院时美国国立卫生研究院卒中量表评分的中位数，M 组高于 N 组（分别为 17 分和 7 分；P=0.196）。M 组和 N 组分别有 4 名和 1 名患者出现院内卒中复发（分别为 36% 对 11%；P=0.319）。大血管闭塞的发生率（M 组 15 例，N 组 10 例，包括院内复发事件）在 M 组明显高于 N 组（分别为 73% 对 30%；P=0.049），这似乎导致 M 组的功能预后差于 N 组（出院时修改的 Rankin 量表评分为 0-2 分的比率分别为 18% 对 44%）：结论：结论：LAT的移动性可能会影响非瓣膜性心房颤动患者中风的严重程度。

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Association between Mobility of Residual Left Atrial Thrombus and Stroke Severity in Patients with Nonvalvular Atrial Fibrillation.

Background: The differences in the characteristics of ischemic stroke associated with a mobile versus nonmobile residual left atrial thrombus (LAT) are unclear. We investigated whether the mobility of an LAT detected by transthoracic echocardiography is associated with the clinical features of stroke.

Methods: This study included 20 consecutive patients with nonvalvular atrial fibrillation who were admitted to our hospital for treatment of acute ischemic stroke and then found to have an LAT on transthoracic echocardiography. The patients were divided into two groups: those with a mobile LAT (Group M) and those with a nonmobile LAT (Group N). The clinical, neuroradiological, and echocardiographic variables were assessed.

Results: The LAT was mobile in 11 patients (Group M) and nonmobile in nine patients (Group N). The median National Institutes of Health Stroke Scale score on admission was higher in Group M than N (17 vs. 7, respectively; p=0.196). Four patients in Group M and one in Group N developed in-hospital stroke recurrence (36% vs. 11%, respectively; p=0.319). The prevalence of large vessel occlusion (15 events in Group M and 10 events in Group N, including in-hospital recurrent events) was significantly higher in Group M than N (73% vs. 30%, respectively; p=0.049), which seemed to lead to poorer functional outcomes in Group M than N (ratio of modified Rankin scale score of 0-2 at discharge: 18% vs. 44%, respectively; p=0.336).

Conclusions: The mobility of LAT may affect stroke severity in patients with nonvalvular atrial fibrillation.

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来源期刊

Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-

CiteScore

1.80

自引率

10.00%

发文量

118

期刊介绍： The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.