Profiles of lacunar and nonlacunar stroke.
Profiles of lacunar and nonlacunar stroke.
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DOI：
10.1002/ana.22497
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发表时间：
2011-09
影响因子：
11.2
通讯作者：
Sharp, Frank R.
中科院分区：
文献类型：
--
作者：
Jickling, Glen C.;Stamova, Boryana;Ander, Bradley P.;Zhan, Xinhua;Tian, Yingfang;Liu, Dazhi;Xu, Huichun;Johnston, S. Claiborne;Verro, Piero;Sharp, Frank R.
确定哪些小深度梗塞 (SDI) 是腔隙性、动脉性或心源性梗塞病因具有挑战性，但对于提供最佳的中风预防治疗非常重要。我们试图使用基因表达谱来区分 SDI 的腔隙性和非腔隙性原因。总共分析了 184 例缺血性中风。腔隙性中风被定义为由穿通动脉供血的区域梗塞<15mm的腔隙综合征。血液中的 RNA 在全基因组微阵列上进行处理。鉴定了腔隙性卒中（n=30）和非腔隙性卒中（n=86）之间差异表达的基因（错误发现率≤0.05，倍数变化>|1.5|）并用于开发预测模型。该模型通过交叉验证和第二个测试队列（n=36）进行评估。使用推导的模型预测原因不明的 SDI（SDI≥15mm 或具有潜在栓塞源的 SDI）（n=32）。 41 个基因谱可区分腔隙性中风和非腔隙性中风，敏感性和特异性超过 90%。在 32 例原因不明的 SDI 中，15 例预计为腔隙性，17 例预计为非腔隙性。确定的特征代表了腔隙性中风和非腔隙性中风之间免疫反应的差异。差异表达基因的概况可以区分腔隙性中风和非腔隙性中风。原因不明的 SDI 通常被预测为非腔隙性病因，这表明 SDI 的全面检查对于识别潜在的心源性栓塞和动脉原因非常重要。需要进一步的研究来评估独立队列中的基因谱，并确定预测的非腔隙性病因的 SDI 的临床和治疗意义。
Determining which small deep infarcts (SDI) are of lacunar, arterial or cardioembolic etiology is challenging, but important in order to deliver optimal stroke prevention therapy. We sought to distinguish lacunar from non-lacunar causes of SDI using a gene expression profile. A total of 184 ischemic strokes were analyzed. Lacunar stroke was defined as a lacunar syndrome with infarction <15mm in a region supplied by penetrating arteries. RNA from blood was processed on whole genome microarrays. Genes differentially expressed between lacunar (n=30) and non-lacunar strokes (n=86) were identified (false discovery rate ≤0.05, fold change>|1.5|) and used to develop a prediction model. The model was evaluated by cross-validation and in a second test cohort (n=36). The etiology of SDI of unclear cause (SDI≥15mm or SDI with potential embolic source) (n=32) was predicted using the derived model. A 41 gene profile discriminated lacunar from non-lacunar stroke with greater than 90% sensitivity and specificity. Of the 32 SDI of unclear cause, 15 were predicted to be lacunar and 17 were predicted to be non-lacunar. The identified profile represents differences in immune response between lacunar and non-lacunar stroke. Profiles of differentially expressed genes can distinguish lacunar from non-lacunar stroke. SDIs of unclear cause were frequently predicted to be of non-lacunar etiology, suggesting comprehensive workup of SDI is important to identify potential cardioembolic and arterial causes. Further study is required to evaluate the gene profile in an independent cohort and determine the clinical and treatment implications of SDI of predicted non-lacunar etiology.
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比较lacunar和非lacunar梗死之间的死亡风险和复发性血管事件。
影响因子：
14.5
作者：
Jackson, C;Sudlow, C
通讯作者：
Sudlow, C
lacunar笔触真的不同吗？对lacunar和非lacunar梗塞之间危险因素概况差异的系统回顾。
影响因子：
8.3
作者：
Jackson, C;Sudlow, C
通讯作者：
Sudlow, C
影响因子：
--
作者：
Bang, OY;Joo, SY;Huh, K
通讯作者：
Huh, K
影响因子：
9.9
作者：
FISHER, CM
通讯作者：
FISHER, CM
影响因子：
8.3
作者：
Cupini, LM;Pasqualetti, P;Bernardi, G
通讯作者：
Bernardi, G