Complex Plaques in the Proximal Descending Aorta An Underestimated Embolic Source of Stroke
Complex Plaques in the Proximal Descending Aorta An Underestimated Embolic Source of Stroke
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DOI：
10.1161/strokeaha.109.577775
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发表时间：
2010-06-01
期刊：
影响因子：
8.3
通讯作者：
Markl, Michael
中科院分区：
文献类型：
--
作者：
Harloff, Andreas;Simon, Jan;Markl, Michael
背景与目的：研究降主动脉（DAo）复杂斑块（>= 4mm厚、溃疡或叠加血栓）逆行血流的发生率及其在栓塞性卒中中的潜在作用。方法：前瞻性纳入94例经食管超声心动图显示主动脉斑块>= 3mm厚的急性脑卒中患者。MRI用于定位复杂斑块并测量主动脉内的时间分辨三维血流。三维可视化评价舒张期逆行血流是否与左锁骨下动脉、左颈总动脉或头臂干出口连接斑块位置。复杂的DAo斑块被认为是栓塞源，如果逆行血流到达主动脉上血管，该血管供应可见急性栓塞性视网膜或脑梗死的区域。结果：仅与心率降低相关(P
Background and Purpose-To investigate the incidence of retrograde flow from complex plaques (>= 4-mm-thick, ulcerated, or superimposed thrombi) of the descending aorta (DAo) and its potential role in embolic stroke.Methods-Ninety-four consecutive acute stroke patients with aortic plaques >= 3-mm-thick in transesophageal echocardiography were prospectively included. MRI was performed to localize complex plaques and to measure time-resolved 3-dimensional blood flow within the aorta. Three-dimensional visualization was used to evaluate if diastolic retrograde flow connected plaque location with the outlet of the left subclavian artery, left common carotid artery, or brachiocephalic trunk. Complex DAo plaques were considered an embolic source if retrograde flow reached a supra-aortic vessel that supplied the territory of visible acute and embolic retinal or cerebral infarction.Results-Only decreasing heart rate was correlated (P