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Published on: August 18, 2015
Total Cerebral Blood Flow in Patients with Cardioembolic Stroke: Is It Clinically Meaningful?
Joan Martí-Fàbregas1, Sebastián Figueroa1, Eva Martínez-Lizana1
1Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
Insights
Reduced total cerebral blood flow (tCBF) in cardioembolic stroke patients did not predict recurrent stroke or vascular events. Further research is needed to understand the role of cerebral blood flow in stroke outcomes.
Area of Science:
- Neurology
- Cardiology
- Vascular Medicine
Background:
- Chronic hypoperfusion may impede emboli clearance and promote thrombus formation in cardioembolic stroke.
- Understanding the impact of reduced cerebral blood flow on stroke recurrence is crucial for patient management.
Purpose of the Study:
- To investigate the association between decreased total cerebral blood flow (tCBF) and the recurrence of stroke and other vascular events in patients with cardioembolic stroke.
- To explore the relationship between tCBF and clinical outcomes, including stroke recurrence, vascular events, and mortality.
Main Methods:
- Seventy-nine patients with cardioembolic stroke (excluding those with extracranial stenosis) were studied.
- Total cerebral blood flow (tCBF) was measured using ultrasonography.
- Patients were followed for stroke recurrence, vascular events, and mortality, with data on demographics, risk factors, and CHA 2 DS 2 -VASc score recorded.
Main Results:
- Mean tCBF was 65.5 mL/100 g/min.
- CHA 2 DS 2 -VASc score and ejection fraction were associated with tCBF.
- After a mean follow-up of 22 months, 7.6% experienced recurrent stroke, 12.7% had vascular events, and 21.5% died.
Conclusions:
- Total cerebral blood flow (tCBF) was not found to be a predictor of clinical outcomes in patients with cardioembolic stroke.
- The study highlights the complexity of stroke recurrence and suggests that tCBF alone may not be sufficient to predict outcomes in this patient population.
Abstract:
Chronic hypoperfusion may hinder the washout of emboli coming from the heart and facilitate the formation of intra-cavitary thrombi. We investigated whether a decreased total cerebral blood flow (tCBF) resulted in recurrence of stroke and other vascular events in consecutive patients with cardioembolic stroke. We excluded patients with extra-cranial carotid or vertebral stenosis. The recorded tCBF was the sum of blood flow in both the carotid and vertebral extra-cranial arteries as measured with ultrasonography. Patients were followed up to assess stroke recurrence, vascular events and mortality. We also recorded demographic data, vascular risk factors, treatment data, echocardiographic variables and the C congestive heart failure history H Hypertension history A Age D Diabetes S Sex S2 Stroke/TIA/Thromboembolism history Vasc Vascular Disease history (CHA2DS2-VASc) score. We studied 79 patients (age 77.9 ± 8.4 y). Mean tCBF was 65.5 ± 15.7 mL/100 g/min. Cox regression analysis found that CHA2 DS2-VASc score and ejection fraction were associated with tCBF. After a mean follow-up of 22 ± 8.5 mo, 7.6% of patients experienced a recurrent stroke, 12.7% experienced a vascular event and 21.5% of patients died. Clinical outcomes were not predicted by tCBF.
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