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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Transient atrial mechanical dysfunction assessed in acute phase of embolic stroke of undetermined source
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Transient atrial mechanical dysfunction assessed in acute phase of embolic stroke of undetermined source

机译：在未确定源的栓塞中风中的急性阶段评估短暂的心房机械功能障碍

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Background and Purpose: Paroxysmal atrial fibrillation (PAF) has been suggested as a major cause of embolic stroke of undetermined source (ESUS). Transient atrial mechanical dysfunction (stunning) frequently occurs after conversion of atrial fibrillation to sinus rhythm. The study aim was to determine if reversible atrial mechanical dysfunction in ESUS could help elucidate the mechanism of stroke. Methods: Eighty-five consecutive patients with acute ischemic stroke were enrolled according to the following inclusion criteria: [1] >= 55 years old; [2] normal sinus rhythm upon admission; [3] no apparent embolic source; and [4] transthoracic echocardiographic evaluation had been performed in both the early phase ( 7 days) after stroke onset. There were 27 patients in the lacunar or atherothrombotic infarction group (controls), 22 in the PAF group, and 36 in the ESUS group. To determine atrial stunning, transmitral flow velocity profiles (Doppler peak E- [early diastolic] and A- [atrial systolic] waves) were obtained. Results: In the early phase, an E/A velocity ratio >= 1.0 was less common in the control group (1 patient, 3.7%) than in the PAF group (19 patients, 86.4%; p < 0.001) and ESUS group (10 patients, 27.8%; p < 0.05). In the late phase, the E/A ratio decreased to less than 1.0 in six patients (31.6%) who had PAF and in eight patients (80.0%) who had ESUS. Conclusion: Transient atrial mechanical dysfunction could be a helpful finding for elucidating the stroke mechanism in patients with ESUS, and early echocardiographic assessment could improve its detection. (c) 2020 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)
机译：背景和目的：阵发性心房颤动（PAF）被认为是不明原因栓塞性卒中（ESUS）的主要原因。短暂性心房机械功能障碍（顿抑）常发生在心房颤动转为窦性心律后。该研究的目的是确定ESUS中可逆性心房机械功能障碍是否有助于阐明中风的机制。方法：85例急性缺血性脑卒中患者根据以下入选标准入选：[1]>=55岁；[2] 入院时窦性心律正常；[3] 无明显栓塞源；[4]在中风发作后的早期（7天）进行了经胸超声心动图评估。腔隙性或动脉粥样硬化性血栓性梗死组（对照组）有27名患者，PAF组有22名患者，ESUS组有36名患者。为了确定心房顿抑，获得了经心房血流速度曲线（多普勒峰值E-[舒张早期]和A-[心房收缩]波）。结果：在早期阶段，对照组（1名患者，3.7%）的E/A速度比>=1.0低于PAF组（19名患者，86.4%；p<0.001）和ESUS组（10名患者，27.8%；p<0.05）。在晚期阶段，6名PAF患者（31.6%）和8名ESUS患者（80.0%）的E/A比率下降至小于1.0。结论：短暂性心房机械功能障碍有助于阐明ESUS患者的卒中机制，早期超声心动图评估可提高其检出率。（c） 2020作者。由爱思唯尔公司出版。这是一篇基于CC by-NC-ND许可证的开放获取文章。(http://creativecommons.org/licenses/by-nc-nd/4.0/)

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