scholarly journals Impact of aortic atheroma and distensibility on diastolic function and prognosis in patients with ischemic stroke

2022 ◽  
Vol 23 (1) ◽  
pp. 1
Author(s):  
Dae-Young Kim ◽  
In-Soo Kim ◽  
Yo Han Jung ◽  
Kyung Yul Lee ◽  
Jong-Youn Kim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Diastolic Function ◽  
Aortic Atheroma

Abstract WP265: Association Between Brachial-Ankle Pulse Wave Velocity and Aortic Atheroma in Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jaewook Jeong ◽  
Jin Kyo Choi ◽  
Young Dae Kim ◽  
Ji Hoe Heo ◽  
Hyo Suk Nam
Keyword(s):  
Ischemic Stroke ◽  
Pulse Wave Velocity ◽  
Acute Ischemic Stroke ◽  
Wave Velocity ◽  
Aortic Stiffness ◽  
Pulse Wave ◽  
Mean Value ◽  
Noninvasive Technique ◽  
Aortic Atheroma ◽  
Aortic Plaques

Background and Purpose: Aortic plaques are associated with both larger artery and small artery atherosclerosis. However, association between aortic plaque and aortic stiffness in ischemic stroke is unknown. Brachial-ankle pulse wave velocity (baPWV) is a noninvasive technique to measure aortic stiffness. In the present study, we hypothesized that presence of aortic plaques is associated with increased baPWV. Methods: We reviewed 1099 patients diagnosed with acute ischemic stroke, who had both transesophageal echocardiography (TEE) and brachial-ankle pulse wave velocity (baPWV) measurements. Aortic plaques were classified as complex aortic plaques (CAP) or simple aortic plaques (SAP). CAP were defined as plaques protruding into the lumen ≥4 mm and of mobile lesions located in the proximal aorta. SAP represented plaques <4 mm in the proximal aorta and plaques located in the descending aorta of any sizes. Patients were classified into 4 groups; patients who have CAP only, those who have SAP only, those who have both CAP and SAP, and those without aortic plaques. Results: Among the 1099 patients, aortic atheroma was found in 689 (62.7%) patients. Twenty one (1.9%) patients had only CAP, 142 (12.9%) patients had both SAP and CAP, while 526 (47.9%) patients had SAP without CAP. Mean value of baPWV was 1982±580 cm/sec. baPWV was significantly increased in patients with any aortic atheromas than those without atheromas (2095±577 cm/sec vs. 1793±535 cm/sec, p <0.001). Analysis of variance showed that baPWV was significantly increased in patients with SAP only (p<0.001) and SAP and CAP (p<0.001) compared to those without any aortic atheroma, whereas CAP only patients were not associated with baPWV (p = 0.131). Conclusion: We found that baPWV was associated with SAP but not CAP in acute ischemic stroke patients. These feature suggests that SAP represent generalized atherosclerosis and aortic stiffness, whereas CAP represent the sole mechanism of stroke.

Aortic atheroma morphology and the risk of ischemic stroke in a multiethnic population

2000 ◽  
Vol 139 (2) ◽  
pp. 0329-0336 ◽  
Author(s):  
Marco R. Di Tullio ◽  
Ralph L. Sacco ◽  
Maria Teresa Savoia ◽  
Robert R. Sciacca ◽  
Shunichi R. Homma
Keyword(s):  
Ischemic Stroke ◽  
Aortic Atheroma ◽  
Multiethnic Population

Abstract WP240: Association Between Mitral and Annular Calcification or Aortic Valve Calcification and Complex Aortic Atheroma in Ischemic Stroke Patients

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kentaro Ishizuka ◽  
Takao Hoshino ◽  
Kyomi Ashihara ◽  
Kazuo Kitagawa
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Aortic Valve ◽  
Transesophageal Echocardiography ◽  
Cryptogenic Stroke ◽  
Aortic Valve Calcification ◽  
Stroke Patients ◽  
Valve Calcification ◽  
Aortic Atheroma ◽  
Annular Calcification

Background and aims: The aim of this study was to investigate the prevalence of mitral annular calcification (MAC) and aortic valve calcification (AVC) according to the presence or absence of complex aortic atheroma (CAA), using transesophageal echocardiography (TEE) data. Methods: This study included 130 (mean age 59.5 years; male 68.5%) consecutive patients who admitted in our hospital with acute ischemic stroke and underwent transesophageal echocardiography (TEE) for determination of stroke etiology during hospitalization. Stroke subtypes were classified with TOAST criteria. Embolic stroke with undetermined source (ESUS) was defined on the basis of the Cryptogenic Stroke/ESUS International Working Group criteria. MAC and AVC were defined as focal areas of high echogenicity of mitral valve annulus and aortic leaflet, respectively. CAA was assessed by TTE and defined as ≥4 mm and/or ulceration and/or mobile plaques. Comparisons were made between patients with and without CAA (CAA and non-CAA group, respectively) with regard to clinical and echocardiological findings. Results: Of the 130 patients, 26 (20.0%) had CAA. The patients in the CAA and non-CAA groups showed significant differences in age (mean, 69.5 vs. 57.0, P < 0.001), hypertension (88.5% vs. 44.2%, P < 0.001), chronic kidney disease (46.2% vs. 22.1%, P = 0.013), diabetes mellitus (61.5% vs. 23.1%, P < 0.001), hyperlipidemia (69.2% vs. 37.5%, P = 0.004), MAC (23.1% vs. 2.9%, P < 0.001), AVC (19.2% vs. 5.8%, P = 0.022), and MAC or/and AVC (34.6% vs. 7.7%, P < 0.001). When restricted to ESUS patients, there were significant differences in age (mean, 65.0 vs. 53.3, P = 0.042), hypertension (mean, 80.0% vs. 43.6%, P = 0.040), history of coronary artery disease (40.0% vs. 2.6%, P < 0.001), diabetes mellitus (60.0% vs. 12.8%, P = 0.001), hyperlipidemia (80.0% vs. 30.8%, P = 0.004), AVC (37.5% vs. 6.8%, P = 0.012), and MAC or/and AVC (34.6% vs. 7.7%, P = 0.030) between the 2 groups, whereas the prevalence of MAC was not different between CAA and non-CCA groups (12.5% vs. 2.3%, P = 0.16). Conclusions: Stroke patients with CAA frequently have concurrent MAC and/or AVC, which may prompt an effort to detect CAA for patients with MAC and /or AVC in transthoracic echocardiography.

Aortic atheroma morphology and the risk of ischemic stroke in a multiethnic population

2000 ◽  
Vol 139 (2) ◽  
pp. 329-336 ◽  
Author(s):  
Marco R Di Tullio ◽  
Ralph L Sacco ◽  
Maria Teresa Savoia ◽  
Robert R Sciacca ◽  
Shunichi Homma
Keyword(s):  
Ischemic Stroke ◽  
Aortic Atheroma ◽  
Multiethnic Population

Significance of aortic atheroma in elderly patients with ischemic stroke

2007 ◽  
Vol 109 (4) ◽  
pp. 311-316 ◽  
Author(s):  
Mohamad Bagher Sharifkazemi ◽  
Amir Aslani ◽  
Mahmood Zamirian ◽  
Ali Reza Moaref
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Aortic Atheroma

scholarly journals Angiotensin II Receptor Blockers or Straight Renin Inhibitor Influence Upon Morphological and Functional Heart and Central Hemodynamics Indices in Hypertensive Patients After Ischemic Stroke

2016 ◽  
pp. 38-47
Author(s):  
Liliana Grubyak ◽  
Maryna Dolzhenko
Keyword(s):  
Ischemic Stroke ◽  
Diastolic Function ◽  
Functional Class ◽  
Renin Inhibitor ◽  
Central Hemodynamics ◽  
Hypertensive Patients ◽  
Nyha Functional Class ◽  
Target Organs ◽  
Significant Difference ◽  
Lv Diastolic Function

Arterial hypertension (AH) in the world and in Ukraine is the main cause of strokes and chronic cerebral dyscirculation with constantly growing incidence. The risk of recurrent stroke grows with increase of concomitant risk factors and AH target organs damage. Asymptomatic target organs damage, especially, LV hypertrophy, etc., is one the potent factors for cerebral vascular complications in hypertensive patients. That is why treatment of heart anatomy alterations, as a target organ, is of great importance in cardiovascular continuum for primary and secondary prevention of cardiovascular, including cerebrovascular end1points. The objective: of the study was to evaluate the influence of AH medication treatment by angiotensin receptors type II blockers (ARB) and straight renin inhibitor upon morphological and functional heart indices and central hemodynamics in hypertensive patients after ischemic stroke (IS) during 1 year follow-up according to stroke and vascular hospital departments experience. Patients and methods. We prospectively included 135 hypertensive pts. without AF history after IS aged 36-78 years  (61,0±9,1 yrs.), hospitalized to stroke and vascular hospital departments of Ternopol regional community psycho-neurological hospital (TRCPNH) over the period Nov. 2011 – Dec. 2013 р. All pts. underwent Doppler EchoCG. Along with fundamental therapy pts. were randomly prescribed Losartan 50-100 mg/day (40 pts.), Olmesartan 20-40 mg/day (48 pts) or Aliskiren 150-300 mg/day. Control EchoCG was performed in 6 and 12 months from trearment start. Results. Among the pts. with AH after IS usually there are pts. with low NYHA class of CHF, with LVEF correlating with NYHA functional class ( –0,47, p<0,0001), with predominantly concentric LV geometry (97,8%), correlating with NYHA functional class. NYHA FC significantly correlates with most morphological and functional left and right remodeling indices, while LV volumes significantly correlate with LV systolic function. ARB administration (Losartan or Olmesartan) for AH treatment leads to marked significant regress of LV hypertrophy and hypertensive remodeling already in 6 months of treatment with central hemodynamics improvement with similar changes in both sartans groups without significant difference between indices. In Aliskiren group (3) in 6 months of treatment pts. Showed significantly higher LA dimensions compared to Losartan group, thicker LV walls compared to both sartan groups, and higher LV RWTh. Central hemodynamics indices, namely, LV diastolic function, LV preload and smaller circulation pressure in 6 months after treatment did not significantly differ between the groups. Conclusions. In Aliskiren group in 12 months of treatment there also were certain positive changes compared to start data, witnessing of reverse LV remodeling. But at the same time Aliskiren group showe significantly higher LV walls thickness (р=0,0051 and р<0,0001 for IVS, and р<0,0001 and р<0,0001 fro LVPW, respectively), and higher LV MMi (р=0,0003 and р=0,0002, respectively) compared both to Losartan and Olmesartan groups, with preservation of concentric LV geometry and LV hypertrophy. Also, Aliskiren group showed significantly worse LV diastolic function and preload indices, allowing to conclude about insufficient cardioprotection with Aliskiren in treating AH after IS, and significant benefit from ARB.

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