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Ischemic Stroke l: Introduction01:15

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Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
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An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
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A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
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Implication of left ventricular diastolic dysfunction in cryptogenic ischemic stroke.

Jae-Young Seo1, Kyung Bok Lee2, Jung-Gon Lee1

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PubMed
Summary

Left ventricular diastolic dysfunction (LVDD) predicts atrial fibrillation (AF). In cryptogenic stroke (CS), severe LVDD is more common in cardioembolism-mimic lesions and may indicate AF, aiding stroke mechanism identification.

Keywords:
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Area of Science:

  • Cardiology
  • Neurology
  • Echocardiography

Background:

  • Left ventricular diastolic dysfunction (LVDD) is a known predictor of atrial fibrillation (AF).
  • The role of LVDD in cryptogenic ischemic stroke (CS) remains unclear.
  • Investigating LVDD in CS may offer insights into stroke mechanisms.

Purpose of the Study:

  • To determine if LVDD in patients with CS can serve as an indicator of stroke mechanism.
  • To compare the prevalence of LVDD in CS with other stroke subtypes.
  • To assess the association between LVDD severity and cardioembolic features in CS.

Main Methods:

  • Retrospective review of 1589 patients with acute ischemic stroke or transient ischemic attack.
  • Grading of LVDD severity (normal, grade I, II, III) using transthoracic echocardiography.
  • Classification of CS lesion patterns into cardioembolism-mimic and non-cardioembolism-mimic.

Main Results:

  • Severe LVDD was significantly more prevalent in CS patients without AF compared to those with AF (27.3% vs 13.4%).
  • Cardioembolism-mimic CS lesions showed significantly higher rates of severe LVDD (41.4%) than non-cardioembolism-mimic lesions (11.5%).
  • LVDD grades II and III were independently associated with stroke with AF after covariate adjustment.

Conclusions:

  • Severe LVDD is a potential predictor of stroke with AF, with similar frequencies observed in CS and stroke with AF.
  • The higher prevalence of severe LVDD in cardioembolism-mimic CS suggests a link to cardioembolic sources.
  • Assessing LVDD may aid in differentiating stroke mechanisms in patients presenting with acute CS.