Echocardiographic Findings And Ischemic Stroke

2011 ◽  
Vol 2 ◽  
Author(s):  
Natalya Gamletovna Dadamyants
Keyword(s):  
Ischemic Stroke ◽  
Heart Defects ◽  
Cerebrovascular Diseases ◽  
Left Ventricular ◽  
Control Group ◽  
Stroke Patients ◽  
Cardiac Pathology ◽  
Normal Limits ◽  
Hemodynamic Stroke ◽  
Echocardiographic Findings

In order to study cardiac pathology in different subtypes of ischemic stroke we examined 165 stroke patients. The 1st group included 90 (54.5%) patients with hemodynamic stroke, the 2nd one - 75 (45.5%) patients with cardioembolic stroke. Control group consisted of 45 individuals without cerebrovascular diseases. Cardiac pathologies with the prevalence of various types of ischemic heart disease were observed in all groups. The parameters of left ventricular stroke volume and ejection fraction were lower in patients with hemodynamic stroke than in other groups, but were within normal limits. Potential sources of cardiogenic embolism were found in all groups: in the 1st group at 74.4%, in the 2nd one at 100%. Thus, most patients with ischemic stroke have different heart defects related to the subtypes of ischemic stroke. 

The relationship between serum and liquor IL-1β, IL-6, TNFa, IL-10 levels and clinical, cognitive and functional characteristics in acute ischemic stroke

2016 ◽  
Vol 94 (9) ◽  
pp. 657-662 ◽  
Author(s):  
Aleksey A. Kulesh ◽  
E. M. Kuklina ◽  
V. V. Shestakov
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Processing Speed ◽  
Cerebrovascular Diseases ◽  
Control Group ◽  
Cerebral Stroke ◽  
Main Process ◽  
Stroke Patients ◽  
Functional Characteristics ◽  
Visual Spatial

Introduction. Inflammation is probably the main process that links cardiovascular risk factors with damage to blood vessels and neurons. Elucidation of mechanisms of this relationship is an important issue. Materials and methods. 70 acute stroke patients were studied to assess their neuropsychological (MMSE, MoCA, FAB, Clock Drawing Test, Shulte Tables and Verbal Fluency) and functional status (mRS, RivermeadMobility Index). The serum and liquor IL-1β, IL-6, TNFa and IL-10 levels were analyzed. Control group included subjects without cerebrovascular diseases. Results. Stroke patients had higher IL-10 serum concentration than controls. No difference was found for other cytokines. There was correlation between serum and liquor cytokines levels. We found positive correlation between IL-1β, IL-6 and IL-10 levels. High IL-1β concentration was associated with vascular riskfactors, cardioembolic stroke, enhanced severity of cerebral stroke, low processing speed, impaired executive and visual-spatial functions and higher grade of mRS on discharge. The same pattern was revealed for IL-6 and IL-10. IL-6 level was related to mRS without relation to NIHSS on admission. High TNFa concentration was linked with vascular riskfactors, low MMSE score and processing speed. Discussion. Despite the antagonistic effects of IL-1β, IL-6 and IL-10 on inflammation, associations of these cytokines with anamnestic, clinical, neuropsychological and functional characteristics were similar in acute ischemic stroke. Probably, this fact indicates that during the acute ischemic brain damage process the immune response develops at the same time in pro- and anti-inflammatory directions. Its magnitude correlates with the damage severity and is associated with the effects of vascular riskfactors before stroke.

scholarly journals The Effectivity of Mirror Therapy on Arm Motoric Improvement in Acute Ischemic Stroke Patients

2019 ◽  
Vol 7 (1) ◽  
pp. 6
Author(s):  
Jumraini Tammasse ◽  
Machyono Andi Kurnia Bintang
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Standard Therapy ◽  
Cerebrovascular Diseases ◽  
Control Group ◽  
Mirror Therapy ◽  
Stroke Patients ◽  
Motor Action ◽  
Significant Difference ◽  
Experimental Group

Cerebrovascular diseases (stroke) ranked the second cause of death worldwide. This research aimed at investigating the effectiveness of mirror therapy on artery therapy by ARAT (ARAT) score. The research was carried out by the clinical trials study towards 32 acute ischemic stroke patients who were divided into an experimental group got the combination of mirror therapy and standard therapy, and the control group only got the standard therapy. The level of the motor action was tested by Action Research Arm Test (ARAT) score. The research then compared the ARAT score difference between the two groups. The result of the research reveals that the ARAT score differences on the group who gets the combination of mirror therapy and standard therapy (15.56±4.38) higher than the group who only gets the standard therapy (7.69±1, 66). By using T-test, it is obtained the significant difference of P <0.05 (0.001).

Risk Factors of Recurrent Ischemic Events after Acute Noncardiogenic Ischemic Stroke

2020 ◽  
Vol 25 (45) ◽  
pp. 4827-4834 ◽  
Author(s):  
Limin Zhang ◽  
Xingang Li ◽  
Dongzhi Wang ◽  
Hong Lv ◽  
Xuezhong Si ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Operating Characteristic ◽  
Control Group ◽  
Case Group ◽  
Stroke Patients ◽  
Clopidogrel Therapy ◽  
Ischemic Events

Background: A considerable proportion of acute noncardiogenic ischemic stroke patients continue to experience recurrent ischemic events after standard therapy. Aim: We aimed to identify risk factors for recurrent ischemic event prediction at an early stage. Methods : 286 non-cardioembolic ischemic stroke patients with the onset of symptoms within 24 hours were enrolled. Vascular risk factors, routine laboratory data on admission, thromboelastography test seven days after clopidogrel therapy and any recurrent events within one year were assessed. Patients were divided into case group (patients with clinical adverse events, including ischemic stokes, transient ischemic attack, myocardial infarction and vascular related mortality) and control group (events-free patients). The risk of the recurrent ischemic events was determined by the receiver operating characteristic curve and multivariable logistic regression analysis. Results: Clinical adverse events were observed in 43 patients (case group). The mean levels of Mean Platelet Volume (MPV), Platelet/Lymphocyte Ratio (PLR), Lymphocyte Count (LY) and Fibrinogen (Fib) on admission were significantly higher in the case group as compared to the control group (P<0.001). Seven days after clopidogrel therapy, the ADP-induced platelet inhibition rate (ADP%) level was lower in the case group, while the Maximum Amplitude (MA) level was higher in the case group as compared to the control group (P<0.01). The Area Under the Curve (AUC) of receiver operating characteristic(ROC) curve of LY, PLR, , Fib, MA, ADP% and MPV were 0.602, 0.614, 0.629, 0.770, 0.800 and 0.808, respectively. The logistic regression analysis showed that MPV, ADP% and MA were indeed predictive factors. Conclusion: MPV, ADP% and MA were risk factors of recurrent ischemic events after acute noncardiogenic ischemic stroke. Urgent assessment and individual drug therapy should be offered to these patients as soon as possible.

Abstract 2922: Patent Foramen Ovale Is A Cause Of Ischemic Stroke In Patients With Antiphospholipid Syndrome

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Yoshiaki Shimada
Keyword(s):  
Ischemic Stroke ◽  
Antiphospholipid Syndrome ◽  
Patent Foramen Ovale ◽  
Multiple Logistic Regression Analysis ◽  
Cryptogenic Stroke ◽  
Control Group ◽  
Atrial Septal Aneurysm ◽  
Foramen Ovale ◽  
Stroke Patients ◽  
Significant Difference

Background: The antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by a combination of arterial and/or venous thrombosis and recurrent fetal loss, and can be an independent risk factor for a first-ever ischemic stroke especially in young female patients. Patent foramen ovale (PFO) has been established as a cause of cryptogenic stroke. Atrial septal aneurysm (ASA) is associated with PFO. Until recently, the precise pathophysiology of APS as causing ischemic stroke has been essentially unknown. In the present study, we investigated the relationship between APS and potential embolic sources including PFO and ASA using transesophageal echocardiography (TEE). Methods: This study was a retrospective case series design. From July 2006 to June 2008, 120 patients with ischemic stroke who admitted to Juntendo University Hospital underwent TEE. In this study period, consecutive ischemic stoke patients diagnosed as APS based on the modified Sapporo criteria were enrolled and classified into APS group. Controls were selected among age- and gender-matched stroke patients without APS who also underwent TEE. We assessed clinical characteristics and presence of embolic sources including PFO and atrial septal aneurysm (ASA) between APS and Control groups. Results: Nine of ischemic stroke patients with APS and 41 controls were included. Primary APS was present in one patient (11.1%) of the APS group, and APS with SLE were found in eight patients (88.9%). There is no significant difference in age, risk factors for ischemic stroke, and MRI findings between two groups. The prevalence of PFO and ASA were significantly higher in APS group compared to Control group (89% vs 41%, P=0.027; 67% vs 20%, P=0.015, respectively). C reactive protein was relatively higher in APS group. Multiple logistic regression analysis showed that PFO (OR: 13.71; 95% CI: 1.01 to 185.62; P=0.049) and ASA (OR: 8.06; 95% CI: 1.17 to 55.59; P=0.034) were independently associated with the APS group. Conclusion: Atrial septal abnormalities including PFO and ASA are strongly associated with APS group, and could be potential embolic sources in ischemic stroke patients with APS.

Abstract TP247: Impact of Helicopter Emergency Medical Services Flights on Recombinant Tissue Plasminogen Activator (rtpa) Integrity

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Brett Faine ◽  
Steven Lentz ◽  
James Torner ◽  
Sanjana Dayal ◽  
Heena Olalde ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Structural Integrity ◽  
Intervention Group ◽  
Recombinant Tissue Plasminogen Activator ◽  
Control Group ◽  
Stroke Patients ◽  
Thrombolytic Activity ◽  
Air Ambulance ◽  
Hospital Transfer ◽  
The Mean

Introduction: Inter-hospital transfer of ischemic stroke patients by Helicopter Emergency Medical Services (HEMS) is common in rural states. The administration of recombinant tissue plasminogen activator (rtPA) is often initiated at the outside hospital and continues during HEMS (drip and ship). Due to the unstable nature of rtPA after reconstitution in conjunction with strong, low frequency vibrations present during HEMS, there is potential for the physical integrity and thrombolytic activity of rtPA to be compromised during inter-hospital transfer. Hypothesis: Air ambulance transfer alters the antigen integrity of rtPA in ischemic stroke patients. Methods: Prospective cohort study of acute ischemic stroke patients receiving rtPA during air ambulance transfer to a comprehensive stroke center (CSC) (intervention group) compared to patients who presented directly to our CSC Emergency Department (control group). The duration of each flight was recorded to control for degree of exposure. To access the structural integrity and thrombolytic activity of rtPA, small residual samples (<0.5 mL) were taken from each patient’s vial after the infusion was completed. The structural integrity of rtPA antigen was evaluated with a specific rtPA protein ELISA. Results: Thirteen patients received rtPA and were transferred to our CSC via our air ambulance service. The mean flight time was 30.6±5.5 minutes. The mean concentration of rtPA in the control sample was 1.035±0.42 mg/mL. The mean difference in the concentration of the rtPA in the intervention group compared to the control group was 1.59±1.28 mg/mL. Conclusions: HEMS transfer appears to increase rtPA antigen concentrations possibly due to degradation. Future analysis will examine whether alteration in integrity of rtPA affects the thrombolytic activity.

Abstract TP418: Impact of Substance Use Disorder on Stroke Outcomes

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Thomas Lawler ◽  
Jessica Lee
Keyword(s):  
Substance Use ◽  
Ischemic Stroke ◽  
Infective Endocarditis ◽  
Control Group ◽  
Stroke Patients ◽  
Drug Induced ◽  
Health Crisis ◽  
Stroke Outcomes ◽  
The Us ◽  
Illicit Substances

Background: Substance abuse is a major health crisis in the US, with an estimated 20 million people suffering from substance use disorders (SUD). In addition to rising rates of SUD, Kentucky is located in the northern region of the stroke belt and has one of the highest rates of stroke hospitalizations in the US. Substance use may cause stroke by various mechanisms, including vasoconstriction, endothelial dysfunction, drug-induced vasculopathies, advanced rates of atherosclerosis, and infective endocarditis. We sought to examine the relationship between SUD and stroke outcomes. Methods: This is a single center, retrospective chart review of adults age >18 years with a diagnosis of ischemic or hemorrhagic stroke, and SUD based on either urine drug testing or medical record history, admitted between 12/6/2015 and 5/10/2019. We collected length of stay (LOS), admission/discharge NIHSS, discharge modified Rankin Scores, ICH scores, and discharge status and compared them to controls of ischemic stroke without SUD. Results: A total of 197 cases were identified [M=147 (74.6%)]. The most common illicit substances identified by testing were stimulants (42.6%, n=84), opioids (32.5%, n=64), and benzodiazepines (28.4%, n=56). Nearly all subjects had multiple substances present on screening. 13.8% (n=27) and 5.6% (n=11) received thrombolysis with either IV alteplase or mechanical thrombectomy, respectively. Compared to a control group of 176 ischemic stroke patients that did not test positive for illicit substances, cases (n= 139, ischemic stroke + SUD) were younger (mean=54.94+/-12.01 vs 66.15 +/- 14.38 yrs , p=0.0137), had a longer LOS (n=139, mean=8.44+/-10.84 vs 5.06 +/- 5.74, p=0.0006), higher admission NIHSS (mean=9.87+/-9.08, p=0.00012), and higher discharge NIHSS (mean=6.51+/-7.13 vs 4.19 +/- 5.73 , p=0.000512). Conclusion: Patients with SUD and stroke had longer LOS and worse discharge NIHSS compared to ischemic stroke patients without SUD. This could be due to the different mechanisms that cause strokes in substance users or could be a reflection of the effects of specific substances present at the time of admission. Future directions will include evaluating a hemorrhagic control population and examining a subpopulation of infective endocarditis.

Abstract TP224: Interleukin-37 Level is Elevated in Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Saif Bushnaq ◽  
Atif Zafar ◽  
Kempuraj Duraisamy ◽  
Nudrat Tasneem ◽  
Mohammad M Khan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Inflammatory Responses ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Delayed Presentation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Urine And Serum ◽  
Serum And Urine

Background: Interleukin-37 (IL-37) is a new member of IL-1 cytokine family with a defined role as a negative feedback inhibitor of pro-inflammatory responses. IL-37 has yet to be evaluated in non-immune neurological diseases like ischemic or hemorrhagic stroke. This study aimed to measure the urine and serum IL-37 levels in patients with acute ischemic stroke. Method: Twelve patients consented for the study. Two sets of serum and urine samples were obtained and analyzed; one upon admission to the hospital, and the second the next morning after overnight fasting. The trends in serum level of IL-37 in 5 stroke patients, while trends in urine level of 6 patients were available, measured by real-time polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). Prior studies with healthy volunteers as control group have consistently showed IL-37 plasma level around or less than 65 pg/ml with maximum normal levels on ELISA approximated at 130 pg/ml. Results: IL-37 level in urine in stroke patients ranged from 297 - 4467. IL-37 levels were in the range of 300s to 1000s in patients with ischemic stroke compared with reported healthy controls in literature where the level was always less than 90. Three of these 10 patients presented within 3 hours of stroke onset with IL-37 serum levels being 2655 pg/ml, 3517 pg/ml and 5235 pg/ml. In all others, it ranged much less than that, with the trend of delayed presentation giving less IL-37 levels, both in urine and serum. There were no clear differences found in patients with or without tPA, diabetes, hyperlipidemia and high blood pressure in our small study. Conclusion: The study shows a rather stable elevation of IL-37 levels post-ischemic stroke, which if compared to available data from other studies, is 3-10 times elevated after acute ischemic stroke with an uptrend in the first few days. IL-37 plays some role in mediating post-stroke inflammation with significant rise in serum and urine IL-37 levels suggesting a key role of this novel cytokine in post-stroke pathology. This is the first ever reported study measuring and trending IL-37 levels in human plasma after an acute ischemic stroke.

Notch3 Mutation Detection in Stroke Patients and Selective Nanoliposome in Stroke Alleviation in a Mouse Model

2021 ◽  
Vol 17 (9) ◽  
pp. 1735-1744
Author(s):  
Yanxia Wang ◽  
Xinmeng Li ◽  
Ying Liu ◽  
Wenjing Guo ◽  
Jiangpo Chen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Mouse Model ◽  
Control Group ◽  
Stroke Therapy ◽  
Stroke Patients ◽  
Brain Vessels ◽  
Stroke Treatment ◽  
Pathological Alteration ◽  
Notch3 Mutation ◽  
Long Term Prognosis

This study analyzed the correlation between the Notch3 mutation and stroke by testing an effective nanoparticle-loaded aspirin in stroke therapy. Fifty patients with ischemic stroke were followed for two years, and fifty healthy persons served as the control group. By RT-PCR, this study revealed that the Notch3 mutation existed in ischemic stroke patients who were more likely to have a family history, small vessel lesions, relatively frequent cerebral hemorrhage, and poor long-term prognosis. Liposome-aspirin-chitosan nanoparticle (LACN) was constructed as a nano-composite for stroke treatment. Notch3 Arg170Cys knock-in mice were prepared as a mutant Notch3 mouse model to test the LACN infiltration efficiency and observe the anti-stroke capacity. We found that LACN could better transport aspirin into brain vessels than the Polyethyleneimine (PEI) delivery system. However, in the Notch3 mutation mouse model, cerebral infarction and hemorrhage often occurred after being treated with aspirin. Still, LACN better prolongs the half-life of aspirin, rescues the pathological alteration of stroke in the brain, and reduces inflammatory reaction and oxidative stress response. In conclusion, the Notch3 mutation is closely related to stroke occurrence, and LACN may be a better choice for stroke therapy in the future.

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.

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