Reduced Left Atrial Rotational Flow Is Independently Associated With Embolic Brain Infarcts.


Journal

JACC. Cardiovascular imaging
ISSN: 1876-7591
Titre abrégé: JACC Cardiovasc Imaging
Pays: United States
ID NLM: 101467978

Informations de publication

Date de publication:
09 2023
Historique:
received: 23 11 2022
revised: 22 02 2023
accepted: 10 03 2023
medline: 8 9 2023
pubmed: 19 5 2023
entrez: 19 5 2023
Statut: ppublish

Résumé

Up to 25% of embolic strokes occur in individuals without atrial fibrillation (AF) or other identifiable mechanisms. This study aims to assess whether left atrial (LA) blood flow characteristics are associated with embolic brain infarcts, independently of AF. The authors recruited 134 patients: 44 with a history of ischemic stroke and 90 with no history of stroke but CHA Patients (41% female; age 70 ± 9 years) had moderate stroke risk (median CHA Reduced LA flow vorticity is significantly and independently associated with embolic brain infarcts. Imaging LA flow characteristics may aid identification of individuals who would benefit from anticoagulation for embolic stroke prevention, regardless of heart rhythm.

Sections du résumé

BACKGROUND
Up to 25% of embolic strokes occur in individuals without atrial fibrillation (AF) or other identifiable mechanisms.
OBJECTIVES
This study aims to assess whether left atrial (LA) blood flow characteristics are associated with embolic brain infarcts, independently of AF.
METHODS
The authors recruited 134 patients: 44 with a history of ischemic stroke and 90 with no history of stroke but CHA
RESULTS
Patients (41% female; age 70 ± 9 years) had moderate stroke risk (median CHA
CONCLUSIONS
Reduced LA flow vorticity is significantly and independently associated with embolic brain infarcts. Imaging LA flow characteristics may aid identification of individuals who would benefit from anticoagulation for embolic stroke prevention, regardless of heart rhythm.

Identifiants

pubmed: 37204381
pii: S1936-878X(23)00149-3
doi: 10.1016/j.jcmg.2023.03.006
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1149-1159

Subventions

Organisme : British Heart Foundation
ID : CH/12/3/29609
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures The study was funded by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre and by the British Heart Foundation (BHF). Drs Spartera, Pessoa-Amorim, and Wijesurendra are funded by the NIHR Oxford BRC. Drs Ferreira and Casadei are funded by the BHF. Drs Spartera, Hess, and Wijesurendra have received support from the BHF Centre of Research Excellence, Oxford. Dr Spartera has received support from a competitive scholarship for young cardiologists awarded by the Italian Society of Cardiology and funded via MSD Italia–Merck Sharp and Dohme Corp. Dr Casadei has received support in kind from Roche Diagnostics (blood assays) and iRhythm (ECG monitors) for clinical studies on atrial fibrillation. Dr Wijesurendra has received travel assistance from Abbott. Dr Harston has received funding from Brainomix Limited. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Auteurs

Marco Spartera (M)

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom. Electronic address: marco.spartera@gmail.com.

Antonio Stracquadanio (A)

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.

Guilherme Pessoa-Amorim (G)

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom; CTSU Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

George Harston (G)

Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.

Sara Mazzucco (S)

Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom; Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, Oxford, United Kingdom.

Victoria Young (V)

Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.

Adam Von Ende (A)

CTSU Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

Aaron T Hess (AT)

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom.

Vanessa M Ferreira (VM)

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.

James Kennedy (J)

Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.

Stefan Neubauer (S)

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.

Barbara Casadei (B)

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.

Rohan S Wijesurendra (RS)

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom; CTSU Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

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