Abstract W P193: Clinical Usefulness of Contrast-Enhancement Cardiac Magnetic Resonance on Detecting Left Ventricular Thrombus in Acute Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Junji Takasugi ◽  
Hiroshi Yamagami ◽  
Teruo Noguchi ◽  
Yoshiaki Morita ◽  
Tomotaka Tanaka ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Acute Ischemic Stroke ◽  
Contrast Enhancement ◽  
Left Ventricular ◽  
Inferior Wall ◽  
Large Artery ◽  
Stroke Patients ◽  
Lv Dysfunction

Objective: Although anticoagulants are recommended in patients with left ventricular (LV) thrombi following myocardial infarction (MI) or LV dysfunction for preventing ischemic stroke, it remains unknown what imaging modality is useful. We sought to detect LV thrombi in acute ischemic stroke patients using contrast-enhancement cardiac magnetic resonance (CE-CMR). Methods: Between February and July 2014, 232 consecutive patients with acute ischemic stroke were admitted to our stroke center within 48 hours after the onset. Among them, patients with a prior MI or systolic LV dysfunction (LV ejection fraction [LVEF] <50%) were prospectively enrolled. CE-CMR and conventional transthoracic echocardiography (TTE) were performed within 7 days from admission. Clinical characteristics and parameters of CE-CMR were analyzed to predict LV thrombus. Results: Twenty-two patients (18 men, 74±12 years old) were enrolled. They consisted of 14 (64%) patients with a prior MI and 8 (36%) patients with LV dysfunction. Two (9%) patients had been treated with anticoagulants before the onset of stroke. The stroke subtypes were classified as follows; cardioembolism in 16 (73%), large-artery atherosclerosis in 3 (14%), small-vessel occlusion in 1 (4%), and others in 2 (9%). LV thrombus was identified in 4 patients (18%) by CE-CMR, whereas only 1 patient was detected by TTE. The locations of LV thrombi were apex (n=2), inferior wall (n=1), and lateral wall (n=1), respectively. Patients with LV thrombus had significantly larger LV end-diastolic (275±89 vs. 182±55ml, p = 0.011) and end-systolic volumes (229±88 vs. 114± 52ml, p = 0.009), and lower LVEF (18±6 vs. 40±11%, p = 0.006) than those without. Conclusion: In acute ischemic stroke patients with prior MI or LV dysfunction, CE-CMR was a useful tool for detecting LV thrombus in comparison with TTE. CE-CMR could identify the patients who need anticoagulant therapy.

scholarly journals Advanced cardiac magnetic resonance imaging in takotsubo cardiomyopathy

2020 ◽  
Vol 93 (1115) ◽  
pp. 20200514
Author(s):  
Vineeta Ojha ◽  
Rishabh Khurana ◽  
Kartik P Ganga ◽  
Sanjeev Kumar
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Takotsubo Cardiomyopathy ◽  
Left Ventricular ◽  
Diagnostic Modality ◽  
Coronary Syndrome ◽  
Lv Dysfunction ◽  
Reversible Condition

Takotsubo cardiomyopathy (TC) is a reversible condition in which there is transient left ventricular (LV) dysfunction characterised most commonly by basal hyperkinesis and mid-apical LV ballooning and hypokinesia. It is said to be triggered by stress and mimics, such as acute coronary syndrome (ACS) clinically. Diagnosis is usually suspected on echocardiography due to the characteristic contraction pattern in a patient with symptoms and signs of ACS but normal coronary arteries on catheter angiography. Cardiac magnetic resonance (CMR), with its latest advancements, is the diagnostic modality of choice for diagnosis, prognosis and follow-up of patients. The advances in CMR (including T1, T2, ECV mapping and threshold-based late gadolinium enhancement (LGE) measurements have revolutionised the role of CMR in tissue characterisation and prognostication in patients with TC. In this review, we highlight the current role of CMR in management of TC and enumerate the CMR findings in TC as well the current advances in the field of CMR, which could help in prognosticating these patients.

scholarly journals The Role of Ejection Fraction to Clinical Outcome of Acute Ischemic Stroke Patients

2018 ◽  
Vol 09 (02) ◽  
pp. 197-202 ◽  
Author(s):  
Fidha Rahmayani ◽  
Ismail Setyopranoto ◽  
Keyword(s):  
Ischemic Stroke ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Acute Ischemic Stroke ◽  
Clinical Outcomes ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Stroke Patients ◽  
Ventricular Ejection Fraction

ABSTRACT Aims: The aim of the study was to determine the effect of left ventricular ejection fraction on clinical outcomes of acute ischemic stroke patients. Study Design: This study design was a prospective cohort observational study. Place and Duration of Study: This study was conducted at Stroke Unit, Neurology Ward, and Cardiology Ward at the Dr. Sardjito Hospital, Yogyakarta, Indonesia, between July and December 2016. Materials and Methods: Hospitalized acute ischemic stroke patients were recruited, with sample was taken by consecutive sampling until reaching amount fulfilling inclusion criterion was 62 persons. In this study, clinical outcomes were measured by National Institutes of Health Stroke Scale (NIHSS) scores as well as dependent variables and left ventricular ejection fraction as independent variables. Logistic regression analyses were performed to discover any potential independent variable that can influence the left ventricular ejection fraction role at the clinical outcomes with NIHSS scores. Results: Multivariate analyses revealed that several variables were significantly interacted with the influence of left ventricular ejection fraction at the clinical outcomes with NIHSS scores. These variables were the left ventricular ejection fraction <48% (95% confidence interval [CI]: 0.691–0.925; P = 0.001), left ventricular ejection fraction + low high-density lipoprotein (HDL) (95% CI: 0.73–0.949; P = 0,001), left ventricular ejection fraction + diabetes mellitus (DM) (95% CI: 0.799–0.962; P = 0,001), and left ventricular ejection fraction + low HDL + DM (95% CI: 0.841–0.98; P = 0,001). Conclusion: The influence of the lower left ventricular ejection fraction to clinical outcome of ischemic stroke patients has a worsening of neurological deficit outcome by considering the combination of several independent variables including the DM and low HDL.

scholarly journals Mechanical thrombectomy in acute ischemic stroke patients with left ventricular assist device

2020 ◽  
Vol 418 ◽  
pp. 117142 ◽  
Author(s):  
Takaya Kitano ◽  
Manabu Sakaguchi ◽  
Hiroshi Yamagami ◽  
Tatsuya Ishikawa ◽  
Hatsue Ishibashi-Ueda ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Mechanical Thrombectomy ◽  
Left Ventricular ◽  
Stroke Patients ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

D-dimers increase in acute ischemic stroke patients with the large artery occlusion, but do not depend on the time of artery recanalization

2009 ◽  
Vol 29 (4) ◽  
pp. 477-482 ◽  
Author(s):  
David Školoudík ◽  
Michal Bar ◽  
Daniel Šaňák ◽  
Petr Bardoň ◽  
Martin Roubec ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Artery Occlusion ◽  
Large Artery ◽  
Stroke Patients

Abstract TP219: Hyperintense Vessels on FLAIR MRI Suggest Dissection and Large-Artery Atherosclerosis but Do Not Predict Outcome in Acute Posterior Circulation Infarct

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Maki Takahashi ◽  
Takeo Sato ◽  
Takahiro Maku ◽  
Haruhiko Motegi ◽  
Hiroki Takatsu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Posterior Circulation ◽  
Unfavorable Outcome ◽  
Artery Dissection ◽  
Large Artery ◽  
Intracranial Artery ◽  
Stroke Patients ◽  
Intracranial Artery Dissection ◽  
Posterior Circulation Infarct

Background and Purpose: Hyperintense vessel sign on FLAIR (HVS) has been described in hyperacute stroke patients with arterial occlusion. It’s a surrogate marker for stroke severity in patients with acute ischemic stroke of the anterior circulation. We aimed to reveal the clinical significance of HVS in patients with acute posterior circulation infarction. Methods: This observational study is based on a single-center prospective registry study. Inclusion criteria were: symptomatic ischemic stroke patients who have lesions only in posterior circulation; and taken initial MRI within 14 days from onset.An unfavorable outcome was defined as mRS score of 2 to 6 at 3 months from the onset. First investigation is to estimate whether HVS could be related to the subtype of acute ischemic stroke (cohort A). Second, the correlation between HVS and mRS at 3 months was evaluated (cohort B). Results: From October 2012 to May 2019, consecutive 1,079 ischemic stroke subjects were screened, including 277 in cohort A (191 male, median age 64 years) and 240 in cohort B (165 male, median age 66 years, Figure A). In cohort A, HVS was independently associated with intracranial artery dissection (OR 5.228; 95% CI 2.270-12.039; p = 0.001) and large-artery atherosclerosis (OR 3.582; 95% CI 1.244-10.317; p = 0.018, Figure B). In cohort B, HVS was not a factor independently associated with unfavorable outcome (OR 2.925; 95% CI 0.881-9.714; p = 0.080). Conclusions: HVS in patients with posterior circulation infarct suggests intracranial artery dissection or large-artery atherosclerosis, but does not have impact on their clinical courses.

Abstract TP136: Dual versus Mono Antiplatelet Therapy in Acute Ischemic Stroke Patients Due to Large Artery Atherosclerosis

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Dohoung Kim ◽  
Jong-Moo Park ◽  
Yong-Jin Cho ◽  
Kyung Bok Lee ◽  
Tai Hwan Park ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Antiplatelet Therapy ◽  
Large Artery ◽  
Stroke Patients ◽  
Dual Versus

Reliability of fast magnetic resonance imaging for acute ischemic stroke patients using a 1.5-T scanner

2018 ◽  
Vol 29 (5) ◽  
pp. 2641-2650 ◽  
Author(s):  
Mi Sun Chung ◽  
Ji Ye Lee ◽  
Seung Chai Jung ◽  
Seunghee Baek ◽  
Woo Hyun Shim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Acute Ischemic Stroke ◽  
Resonance Imaging ◽  
Stroke Patients ◽  
Fast Magnetic Resonance Imaging

scholarly journals Functional recovery after percutaneous revascularization of coronary chronic total occlusions: insights from cardiac magnetic resonance tissue tracking

2021 ◽  
Author(s):  
Henk Everaars ◽  
Stefan P. Schumacher ◽  
Wijnand J. Stuijfzand ◽  
Martijn van Basten Batenburg ◽  
Jennifer Huynh ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Strain Improvement ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Lv Function ◽  
Chronic Total Occlusions ◽  
Lv Dysfunction ◽  
Tissue Tracking ◽  
Percutaneous Revascularization

AbstractTo evaluate the effect of percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTOs) on left ventricular (LV) strain assessed using cardiac magnetic resonance (CMR) tissue tracking. In 150 patients with a CTO, longitudinal (LS), radial (RS) and circumferential shortening (CS) were determined using CMR tissue tracking before and 3 months after successful PCI. In patients with impaired LV strain at baseline, global LS (10.9 ± 2.4% vs 11.6 ± 2.8%; P = 0.006), CS (11.3 ± 2.9% vs 12.0 ± 3.5%; P = 0.002) and RS (15.8 ± 4.9% vs 17.4 ± 6.6%; P = 0.001) improved after revascularization of the CTO, albeit to a small, clinically irrelevant, extent. Strain improvement was inversely related to the extent of scar, even after correcting for baseline strain (B =  − 0.05; P = 0.008 for GLS, B =  − 0.06; P = 0.016 for GCS, B =  − 0.13; P = 0.017 for GRS). In the vascular territory of the CTO, dysfunctional segments showed minor improvement in both CS (10.8 [6.9 to 13.3] % vs 11.9 [8.1 to 15.0] %; P < 0.001) and RS (14.2 [8.4 to 18.7] % vs 16.0 [9.9 to 21.8] %; P < 0.001) after PCI. Percutaneous revascularization of CTOs does not lead to a clinically relevant improvement of LV function, even in the subgroup of patients and segments most likely to benefit from revascularization (i.e. LV dysfunction at baseline and no or limited myocardial scar).

scholarly journals Left Ventricular Magnetic Resonance Imaging Strain Predicts the Onset of Duchenne Muscular Dystrophy–Associated Cardiomyopathy

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Saira Siddiqui ◽  
Tarek Alsaied ◽  
Sarah E. Henson ◽  
Janvi Gandhi ◽  
Priyal Patel ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Duchenne Muscular Dystrophy ◽  
Magnetic Resonance ◽  
Muscular Dystrophy ◽  
Ejection Fraction ◽  
Radial Strain ◽  
Left Ventricular ◽  
3 Dimensional ◽  
Lv Dysfunction ◽  
Lv Ejection Fraction

Background: Early detection of left ventricular (LV) dysfunction before the onset of overt Duchenne muscular dystrophy–associated cardiomyopathy (DMDAC) may direct clinical management to slow onset of dysfunction. We aimed to assess whether LV strain will predict those who develop DMDAC. Methods: We performed a single center retrospective case control study of patients with Duchenne muscular dystrophy who underwent serial cardiac magnetic resonance between 2006 and 2019. Patients with Duchenne muscular dystrophy with an LV ejection fraction ≥55% on ≥1 cardiac magnetic resonance were identified and grouped into age-matched +DMDAC and –DMDAC. Within 3 years, +DMDAC had a subsequent cardiac magnetic resonance with a decline in LV ejection fraction ≥10% and absolute LV ejection fraction ≤50%. −DMDAC maintained an LV ejection fraction ≥55% on serial cardiac magnetic resonances. Two-dimensional and 3-dimensional global radial strain, global circumferential strain (GCS), and global longitudinal strain were measured using tissue tracking software and their ability to predict DMDAC onset was assessed. Multivariable analysis adjusted for late gadolinium enhancement. Results: Thirty +DMDAC and 30 age-matched −DMDAC patients were included with a total of 164 studies analyzed. Before DMDAC onset, 2-dimensional global radial strain and GCS were significantly worse in +DMDAC compared with −DMDAC (25.1±6.0 versus 29.0±6.3, P =0.011; −15.4%±2.4 versus −17.3%±2.6, P =0.003). Three-dimensional GCS and global radial strain had similar findings. Among strain measures, 3-dimensional GCS had the highest area under the curve to predict DMDAC in our cohort. These findings persisted after adjusting for the presence of late gadolinium enhancement. Conclusions: Reduced global radial strain and GCS may predict those at risk for developing DMDAC before onset of LV dysfunction and its clinical utility warrants further exploration.

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