Abstract
Background: Considering high mortality and recurrent stroke risks of cardioembolic stroke, detecting sources of embolism is important for optimizing treatment for potential cardioembolic stroke (PCS). We propose that different patterns of regional wall motion abnormality (RWMA) may provoke imbalance of heart contractility and may affect on PCS. Therefore, the aim of this study was to evaluate the territorial impact of RWMA on PCS.
Methods: We classified the patients into 2 groups: PCS and non-PCS. We classified the patient's RWMA into 3 major arterial territories based on the standard 17-segment model of TTE findings at the acute stroke period.
Results: Among a total of 1858 patients, 621 (33.4%) had PCS. Patients with PCS were more likely to have larger left ventricular internal dimension at diastole, larger left ventricular internal dimension at systole, reduced left ventricular ejection fractions, larger left atrial sizes, reduced mitral deceleration time, increased E/A ratios and regional wall motion abnormality, aortic valve disease, mitral valve disease. After adjusting for multiple clinical and TTE parameters including AF, binary logistic regression demonstrated that RWMA of LAD had a significant predictive value for PCS (OR 4.15, 95% CI: 1.81–9.51, p < 0.01).
Conclusion: In conclusion, we suggest that RWMA of LAD was a significant predictor for PCS. The RWMA of LAD seems to have hemodynamic significance for cardiac wall perfusion in cardiac side. However, considering the risk of PCS in brain side, it might be needed to plan more aggressive treatment for lesion of LAD than for those of non-LAD arteries.
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© 2015 Published by Elsevier Inc.
