A transesophageal echocardiographic study on risk factors for stroke in elderly patients with atrial fibrillation: a comparison with younger patients.
A transesophageal echocardiographic study on risk factors for stroke in elderly patients with atrial fibrillation: a comparison with younger patients.
复制标题
老年房颤患者卒中危险因素的经食管超声心动图研究：与年轻患者的比较。
DOI：
10.1378/chest.120.3.840
复制
发表时间：
2001
期刊：
影响因子：
9.6
通讯作者：
Hiroshi Inoue
中科院分区：
文献类型：
--
作者：
N. Shinokawa;T. Hirai;S. Takashima;T. Kameyama;K. Nakagawa;H. Asanoi;Hiroshi Inoue
研究目标
STUDY OBJECTIVES
Atrial fibrillation (AF) becomes an increasingly important cause of stroke as patients get older. The aim of the study was to determine whether risk factors of cerebral embolism among elderly patients with AF differed from those of younger patients by using transesophageal echocardiography (TEE).
DESIGN AND SETTING
Cross-sectional study at a university hospital.
METHODS
Cardiovascular lesions with the potential for thromboembolism in patients with AF were investigated using TEE. Left atrial spontaneous echocardiographic contrast (SEC), peak flow velocity in the left atrial appendage (LAA-flow), and aortic atherosclerosis of the thoracic aorta were assessed in 67 elderly (> or = 70 years old) and 135 younger (< 70 years old) patients. All patients underwent either brain CT (n = 54) or MRI (n = 148) to assess presence of cerebral infarction.
RESULTS
Cerebral infarction due to embolism was noted in 113 patients with AF. There was a higher prevalence of cerebral embolism in elderly patients when compared with younger patients (78% vs 45%; p < 0.001). Cerebral embolism found in younger patients was associated with high grade of SEC and lower LAA-flow (p < 0.05). In addition to these TEE findings, aortic atherosclerosis was more severe in elderly patients with cerebral embolism than in those without cerebral embolism (p < 0.0001). By multivariate logistic analysis, LAA-flow was an independent predictor of cortical infarction in younger patients, but not in elderly patients, whereas aortic atherosclerosis was a useful marker in predicting embolic risk in elderly patients.
CONCLUSIONS
TEE findings indicative of left atrial blood stasis were useful to identify the embolic risk of younger patients with AF, while atherosclerosis of the thoracic aorta appears to be an important marker for cerebral embolism in elderly patients.
超声心动图“烟雾”是由剪切力调节的红细胞和血浆蛋白相互作用产生的。
影响因子：
24
作者：
Merino,A;Hauptman,P;Badimon,L;Badimon,JJ;Cohen,M;Fuster,V;Goldman,M
通讯作者：
Goldman,M
DOI：
10.1016/s0735-1097(98)00146-6
发表时间：
1998-06-01
影响因子：
24
作者：
Zabalgoitia, M;Halperin, JL;Hart, RG
通讯作者：
Hart, RG
影响因子：
--
作者：
通讯作者：
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