Association of inferior division MCA stroke location with populations with atrial fibrillation incidence.
Association of inferior division MCA stroke location with populations with atrial fibrillation incidence.
复制标题
MCA 下分区卒中位置与心房颤动发病率人群的关联。
DOI：
10.1016/j.heliyon.2023.e15287
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发表时间：
2023
期刊：
影响因子：
4
通讯作者：
Faria,AndreiaV
中科院分区：
文献类型：
--
作者：
Kim,Ganghyun;Vitti,Emilia;Stockbridge,MelissaD;Saver,JeffreyL;Hillis,ArgyeE;Faria,AndreiaV
背景与目的：考虑到大脑中动脉（MCA）分叉的解剖特点，较大的栓子更容易进入下分支而不是上分支。由于心脏源性栓塞比动脉源性栓塞平均更大，我们假设颞叶和顶叶梗死比额叶梗死更可能与心房颤动相关，因此在心房颤动发病率较高的人群中更常发生，例如男性（与女性相比）和白人（与黑人相比）患者。方法：我们纳入197例MCA“颞顶叶为主”梗死患者和105例“额叶为主”梗死患者。脑卒中部位（额叶或颞顶叶）、性别和种族之间的差异通过卡方检验进行检验。结果：男性患者患颞顶叶中风的可能性大于女性患者，白人患者患颞顶叶中风的可能性大于黑人患者。确诊为房颤的患者比额叶卒中更容易出现颞顶卒中。结论：颞顶叶MCA缺血性中风在男性和白人患者中更常见，这些人群已知房颤发病率较高。此外，MCA分支的人群特异性解剖特征可能有利于较大的心脏栓塞进入下分支并引起颞顶梗死。这种关联有助于指导寻找最可能的梗死病因。
Background and Aim: Considering the anatomical features of Middle Cerebral Artery (MCA) bifurcation, larger emboli are more likely to enter the inferior division over the superior division. Since emboli of cardiac origin are larger on average than emboli of arterial origin, we hypothesize that the infarcts in temporal and parietal lobes are more likely associated to atrial fibrillation than those in the frontal lobes, therefore occurring more often in populations with higher incidence of atrial fibrillation, such as male (compared to women) and white (compared to black) patients.Methods: We included 197 patients with MCA "temporoparietal predominant" infarcts and 105 with "frontal predominant" infarcts. Variations between stroke location (frontal or temporoparietal), sex, and race were examined via Chi-square test.Results: Male patients were more likely than female patients to be afflicted by temporoparietal strokes versus frontal strokes, while white patients had greater likelihood than black patients to be afflicted by temporoparietal strokes versus frontal strokes. Patients with confirmed diagnosis of atrial fibrillation display more temporoparietal strokes compared to frontal strokes.Conclusion: Temporoparietal MCA ischemic strokes occur more frequently in male and white patients: populations with known increased incidence of atrial fibrillation. In addition, population-specific anatomical characteristics of the MCA bifurcation might favor the larger cardiac emboli to enter the inferior division and cause temporoparietal infarcts. This association can help guide search for the most likely etiology of infarcts.