Inflammation and Atrial Electrical Remodelling in Patients With Embolic Strokes of Undetermined Source
Inflammation and Atrial Electrical Remodelling in Patients With Embolic Strokes of Undetermined Source
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DOI：
10.1016/j.hlc.2018.04.294
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发表时间：
2019-06-01
影响因子：
2.6
通讯作者：
Martini, Giuseppe
中科院分区：
文献类型：
--
作者：
Acampa, Maurizio;Lazzerini, Pietro Enea;Martini, Giuseppe
背景大约三分之一的缺血性卒中被归类为来源不明的栓塞性卒中(ESU)。静止性房颤(AF)可能在这些卒中中起致病作用，P波离散度(PWD)是阵发性房颤的心电图预测指标，因此是隐匿性心梗的潜在标志物。此外，目前的证据将房颤与炎症联系起来：炎症标记物，如高敏C反应蛋白(HsCRP)，可能通过促进心房重构与房颤的发生和持续有关。这项研究的目的是评估在ESUS患者中是否存在PWD和hsCRP之间的关系，以强调炎症在易患AR的心房电重构中的可能作用。方法我们收集了174例ESUS患者(男性91例，女性83例；平均年龄69±13岁)。所有患者均接受神经影像检查、动脉超声检查、超声心动图和心电图检查。结果P波离散度与超敏C反应蛋白呈显著正相关(r=0.35，P<0.0001)。在高PWD患者(>；40毫秒；n=102)中，hsCRP是PWD正常患者的三倍(
Background About one third of ischaemic strokes are classified as embolic strokes of undetermined source (ESUS). A silent atrial fibrillation (AF) may play a pathogenic role in these strokes and P wave dispersion (PWD), representing an electrocardiographic (ECG) predictor for paroxysmal AF, thereby a potential marker of covert cardioembolism, was found to be increased in cryptogenic stroke. Furthermore, current evidence links AF to inflammation: inflammatory markers, such as high-sensitive C-reactive protein (hsCRP), have been related to the development and persistence of AF, possibly by promoting atrial remodelling. The aim of this study was to evaluate whether a relationship between PWD and hsCRP in patients with ESUS exists, in order to highlight a possible role for inflammation in the atrial electric remodelling, that predisposes to AR.Methods We enrolled 174 patients (91 males, 83 females; mean age 69 +/- 13 years) with ESUS. All patients underwent neuroimaging examination, arterial ultrasound examination, echocardiography and ECG. P wave dispersion and hsCRP were measured in all subjects.Results A significant positive correlation was found between hsCRP and PWD (Spearman r: 0.35, p < 0.0001). In patients with high PWD (>40 msec; n = 102), hsCRP was three-fold higher than in patients with normal PWD (