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Stroke severity in concomitant cardiac sources of embolism in patients with atrial fibrillation

 Young Dae Kim  ;  Bosuk Park  ;  Myoung Jin Cha  ;  Chung Mo Nam  ;  Hyo Suk Nam  ;  Jong Won Ha  ;  Namsik Chung  ;  Ji Hoe Heo 
 JOURNAL OF THE NEUROLOGICAL SCIENCES, Vol.298(1-2) : 23-27, 2010 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Atrial Fibrillation/complications* ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/pathology* ; Cerebral Angiography ; Cerebral Infarction/pathology ; Echocardiography, Transesophageal ; Embolism/complications* ; Embolism/diagnostic imaging ; Embolism/pathology* ; Female ; Heart Diseases/complications* ; Heart Diseases/diagnostic imaging ; Heart Diseases/pathology* ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Registries ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sex Characteristics ; Stroke/complications* ; Stroke/diagnostic imaging ; Stroke/pathology*
Stroke ; Brain embolism ; Prognosis ; Transesophageal echocardiography
BACKGROUND: Atrial fibrillation (AF), which is the most common etiology of cardioembolic stroke, may be accompanied by other cardiac sources of embolism. The heterogeneity and multiplicity of the cardiac sources of embolism may influence stroke severity via formation of thrombi with heterogenous compositions, ages, and sizes. We investigated among stroke patients with AF whether stroke severity is different between patients with concomitant potential cardiac sources of embolism and those without. METHODS: The subjects for this study were consecutive patients with cerebral infarction and AF who underwent transesophageal echocardiography during a 10-year period. The definitions and determination of high- and medium-risk potential cardiac sources of embolism were based on the Trial of Org 10172 in Acute Stroke Treatment classification. Initial stroke severity and infarct sizes were compared between patients with concomitant potential cardiac sources of embolism and those without. RESULTS: Of the 266 patients enrolled, 181 (68.0%) had one or more concomitant potential cardiac sources of embolism. Left atrial thrombus and spontaneous echo contrast were most common. Patients with concomitant potential cardiac sources of embolism had a higher median score on the initial National Institute of Health Stroke Scale (6 vs. 3, p=0.005) and a larger infarction diameter (45.4±31.3 mm vs. 35.5±26.6 mm, p=0.002) than those without. Occlusion of the symptomatic arteries was more frequently detected in patients with concomitant potential cardiac sources of embolism. CONCLUSIONS: Stroke patients with AF frequently had concomitant potential cardiac sources of embolism, and strokes were more severe in them
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Chung, Nam Sik(정남식)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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