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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“心脏病”的生物标志物与栓塞性卒中风险相关。然而，目前尚不清楚这种风险是否由未诊断的阵发性心房颤动或扑动（AF）介导。我们的目的是确定在来源不明的栓塞性卒中（ESUS）后，心房性心脏病生物标记物是否能在持续心律监测中预测房颤。方法：这是一项单中心回顾性研究，包括2013年1月1日至2015年12月31日期间接受30天动态心律监测以寻找房颤的所有ESUS患者。我们回顾了临床、影像学和心脏变量的医疗记录。主要结果是在心律监测期间检测到房颤的新诊断。主要预测因素是心房生物标志物：超声心动图上的左心房直径、心电图（ECG）V1导联上的P波终末力和ECG上的P波-R波（PR）间期。采用多元逻辑回归模型评估心房生物标志物与房颤检测之间的关系。结果：在196名符合条件的患者中，23名（11.7%）被诊断为房颤。在未经调整的分析中，房颤患者年龄较大（72.4岁对61.4岁，P<0.001），左心房直径较大（39.2毫米对35.7毫米，P=0.03）。在多变量模型中，房颤的唯一预测因素是年龄=60岁（优势比，3.0；95%可信区间，1.06-8.5；P=0.04）。结论：心房生物标志物与ESUS术后房颤的相关性较弱。这表明先前报道的这些标记物与卒中之间的相关性可能反映了导致卒中的独立心脏通路。需要进行前瞻性研究来研究这些机制。

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