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Different infarction patterns in patients with aortic atheroma compared to those with cardioembolism or large artery atherosclerosis

Title
Different infarction patterns in patients with aortic atheroma compared to those with cardioembolism or large artery atherosclerosis
Authors
Kim, Seung WooKim, Young DaeChang, Hyuk-JaeHong, Geu-RuShim, Chi YoungChung, Seok JongHong, Jin YongSong, Tae-JinSong, DongbeomBang, Oh YoungHeo, Ji HoeNam, Hyo Suk
Ewha Authors
송태진
SCOPUS Author ID
송태진scopus
Issue Date
2018
Journal Title
JOURNAL OF NEUROLOGY
ISSN
0340-5354JCR Link1432-1459JCR Link
Citation
vol. 265, no. 1, pp. 151 - 158
Keywords
Ischemic strokeAortic arch atheromaDiffusion-weighted imagingTransesophageal echocardiography
Publisher
SPRINGER HEIDELBERG
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
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.
DOI
10.1007/s00415-017-8685-7
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의과대학 > 의학과 > Journal papers
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