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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Left Atrium Dilatation and Multiple Vascular Territory Strokes
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Left Atrium Dilatation and Multiple Vascular Territory Strokes

机译：左心房扩张和多发性血管性中风

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Background: Atrial fibrillation (AF) is a cause of ischemic stroke and is associated with recurrence and with acute multivessel territory non lacunar stroke. Many cryptogenic strokes could be secondary to undiagnosed paroxystic AF. As left atrium (LA) dilatation is a risk factor of AF, we sought to determine if moderate or severe LA dilatation was associated with multiple vascular territory infarcts on magnetic resonance imaging (MRI) in patients with acute ischemic stroke without known AF. Normal LA diameter values are <= 4.0 cm for men and <= 3.8 for women. Methods: Patients who presented at our center between 2006 and 2011 with a diagnosis of acute ischemic stroke (AIS) or transient ischemick attack (TIA) who had a transthoracic echocardiography and a brain MRI were included. Patients with known or de novo AF diagnosed within 3 months of the event were excluded. The main outcome was the presence of acute multi-vessel territory infarct(s) on MRI. Results: 356 patients were included. The mean LA diameter was 37 mm in the control group (normal or mildly dilated LA) and 49 mm in those with moderately to severely enlarged LA (p < 0.001). More patients in the LA dilatation group met the main outcome (20% vs 6%; OR 3.89; 95% CI 1.32-11.43; p = 0.0014). Conclusions: LA dilatation (at least moderate) is associated with acute non lacunar multiple vascular territory infarcts on MRI in patients with AIS or TIA without known AF or a confirmed diagnosis of AF. Further studies are necessary to determine if this population might benefit from anticoagulation therapy.
机译：背景：心房颤动（AF）是缺血性中风的原因，与复发和急性多支血管非腔隙性中风有关。许多隐源性中风可能是继发于未确诊的阵发性房颤的继发原因。由于左心房（LA）扩张是房颤的危险因素，我们试图确定在没有已知房颤的急性缺血性卒中患者中，中度或重度LA扩张是否与磁共振成像（MRI）上的多个血管区域梗塞有关。男性的正常LA直径值<= 4.0厘米，女性<= 3.8。方法：纳入2006年至2011年在我们中心就诊的经胸超声心动图和脑部MRI诊断为急性缺血性中风（AIS）或短暂性缺血性发作（TIA）的患者。在事件发生后3个月内被诊断为已知或从发AF的患者被排除在外。主要结局是MRI上存在急性多支血管区域梗塞。结果：纳入356例患者。对照组（正常或轻度扩张的LA）的平均LA直径为37毫米，而中度至严重扩张的LA的平均LA直径为49毫米（p <0.001）。 LA扩张组中更多的患者达到了主要结局（20％比6％; OR 3.89; 95％CI 1.32-11.43; p = 0.0014）。结论：对于没有已知房颤或确诊为房颤的AIS或TIA患者，LA扩张（至少中度）与MRI上的急性非腔隙性多血管区域梗塞相关。有必要进行进一步的研究以确定该人群是否可以从抗凝治疗中受益。

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