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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Biomarkers of Atrial Cardiopathy and Atrial Fibrillation Detection on Mobile Outpatient Continuous Telemetry After Embolic Stroke of Undetermined Source
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Biomarkers of Atrial Cardiopathy and Atrial Fibrillation Detection on Mobile Outpatient Continuous Telemetry After Embolic Stroke of Undetermined Source

机译：栓塞中源源后移动门诊连续遥测的心房心肺病和心房颤动检测的生物标志物

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Background: Biomarkers of atrial dysfunction or "cardiopathy" are associated with embolic stroke risk. However, it is unclear if this risk is mediated by undiagnosed paroxysmal atrial fibrillation or flutter (AF). We aim to determine whether atrial cardiopathy biomarkers predict AF on continuous heart-rhythm monitoring after embolic stroke of undetermined source (ESUS). Methods: This was a single-center retrospective study including all patients with ESUS undergoing 30 days of ambulatory heart-rhythm monitoring to look for AF between January 1, 2013 and December 31, 2015. We reviewed medical records for clinical, radiographic, and cardiac variables. The primary outcome was a new diagnosis of AF detected during heart-rhythm monitoring. The primary predictors were atrial biomarkers: left atrial diameter on echocardiography, P-wave terminal force in electrocardiogram (ECG) lead V1, and P wave - R wave (PR) interval on ECG. A multiple logistic regression model was used to assess the relationship between atrial biomarkers and AF detection. Results: Among 196 eligible patients, 23 (11.7%) were diagnosed with AF. In unadjusted analyses, patients with AF were older (72.4 years versus 61.4 years, P < .001) and had larger left atrial diameter (39.2 mm versus 35.7 mm, P = .03). In a multivariable model, the only predictor of AF was age = 60 years (odds ratio, 3.0; 95% CI, 1.06-8.5; P = .04). Conclusion: Atrial biomarkers were weakly associated with AF after ESUS. This suggests that previously reported associations between these markers and stroke may reflect independent cardiac pathways leading to stroke. Prospective studies are needed to investigate these mechanisms.
机译：背景：心房功能障碍或“心肌病”的生物标志物与栓塞风险有关。但是，如果这种风险是由未确诊的阵发性心房颤动或颤动（AF）介导的这种风险尚不清楚。我们的目标是判断心房心脏病生物标志物是否在未确定源（esus）栓塞中风后的连续心律监测中。方法：这是一项单中心回顾性研究，包括所有患有esus的患者，在2015年1月1日和2015年12月31日之间寻找30天的esus患者。我们审查了临床，射线照相和心脏病的病历变量。主要结果是在心律节律监测期间检测到的新诊断。主要预测因子是心房生物标志物：ECheadarcography上的左心房直径，心电图（ECG）引线V1中的P波端子力和ECG上的P波-R波（PR）间隔。多个逻辑回归模型用于评估心房生物标志物与AF检测之间的关系。结果：196例符合条件的患者中，23名（11.7％）被诊断为AF。在不调整的分析中，AF的患者年龄较大（72.4岁，与61.4岁，P <.001）较大（39.2毫米与35.7 mm，P = .03）。在多变量的模型中，AF的唯一预测因子​​是年龄= 60岁（赔率比，3.0; 95％CI，1.06-8.5; P = .04）。结论：心房生物标志物与eSus后的AF弱相关。这表明，先前报告了这些标志物和中风之间的关联可能反映导致中风的独立心脏途径。需要预期研究来调查这些机制。

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