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[Cardiac pathology in various in various pathogenetic subtypes of ischemic stroke]
Insights
Heart pathology is common in all ischemic stroke subtypes, with cardioembolic stroke patients showing the highest prevalence. Potential causes of cardiocerebral embolism can be found across all stroke types, highlighting the importance of cardiac evaluation.
Area of Science:
- Cardiology
- Neurology
- Stroke Pathogenesis
Context:
- Ischemic stroke encompasses diverse pathogenetic subtypes.
- Understanding the cardiac underpinnings of each subtype is crucial for effective management.
- A significant portion of ischemic strokes are potentially related to cardiac sources.
Purpose:
- To investigate the prevalence and types of cardiac pathology across different pathogenetic subtypes of ischemic stroke.
- To identify potential sources of cardiogenic cerebral embolism in each stroke subtype.
Summary:
- This study analyzed 330 ischemic stroke patients across four subtypes: cardioembolic (31.5%), hemodynamic (21.8%), atherothrombotic (21.5%), and lacunar (25.2%).
- Cardiac pathology was present in all patients with cardioembolic stroke and in a significant percentage of patients in other subtypes (68.1% hemodynamic, 50.7% atherothrombotic, 37.3% lacunar).
- Ischemic heart disease was the most common cardiac pathology, and potential sources of cardiogenic cerebral embolism were identified in all stroke subtypes, though with varying frequencies.
Impact:
- Highlights the ubiquitous role of cardiac pathology in ischemic stroke, irrespective of subtype.
- Underscores the necessity of comprehensive cardiac assessment in all ischemic stroke patients to identify embolism sources.
- Informs clinical practice regarding the differential diagnosis and management strategies for various ischemic stroke subtypes based on cardiac involvement.
Abstract:
Heart pathology was studied in various pathogenetic subtypes of ischemic stroke. A total of 330 stroke patients were divided into 4 groups. Group 1 consisted of 104 (31.5%) patients with cardioembolic stroke, group 2--of 72 (21.8%) with hemodynamic, group 3--of 71 (21.5%) patients with atherothrombotic and group 4--of 83 (25.2%) patients with lacunar stroke. Cardiac pathology was found in all patients of group 1 (ischemic heart disease-50.0%, inflammatory-infectious lesions-27.9%, other lesions-22.1%), in 49 (68.1%) patients of group 2, 36 (50.7%) of group 3 and 31 (37.3%) of group 4. Ischemic heart disease was prevalent (85.7, 86.1, 83.9% vs group 1). Potential sources of cardiogenic cerebral embolia were found in patients of all the groups: 100, 62.5, 43.7 and 33.7%, respectively. Thus, most patients with ischemic stroke have different heart defects related to the subtype of ischemic stroke. Potential causes of cardiocerebral embolism can be detected in any subtype of ischemic stroke.