与不确定来源的栓塞性中风患者心房动检测增加相关的因素
Jia-Yi Wang1, Stephanie Vu2, Matthew McGuinness2
1Department of Neurology, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States.
概括
在源不明的栓塞性中风 (ESUS) 中检测心房动 (AF) 是至关重要的. 左心房尺寸扩大和中心回可能表明,从初始短期心脏监测中受益最多的患者.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗监测 医疗监测
背景情况:
- 不确定来源的栓塞性中风 (ESUS) 后心脏监测持续时间较长与较高的心房 (AF) 检测率有关.
- 与植入式设备相比,14天的表面监视器是ESUS患者常见的,具有成本效益的初始策略.
- 确定从初始监测中获益最多的特定患者子组是必不可少的.
研究的目的:
- 评估心脏标志物是否可以识别ESUS患者可能受益于对心房动 (AF) 的短期监测.
- 为了确定14天表面心脏监测器在检测ESUS患者的AF中的有效性.
- 评估特定的心声回声标记与AF检测的关联.
主要方法:
- 使用14天表面心脏监测 (ZioPatch®) 判断急性缺血性中风患者中风病因.
- 主要结果:在表面监测期间检测到≥30秒的AF.
- 分析包括心电图和心声回声标记器在内的预测因素,使用千平方测试,费舍尔精确测试和年龄调整后勤回归.
主要成果:
- 在415名ESUS患者中,4.3%的患者在监测期间发生了AF.
- 在左心室尺寸膨胀 (9.6%) 和心心回 (8.0%) 的患者中,AF检测率更高.
- 左心房尺寸扩大与AF检测的几率增加显著相关 (OR 3.17).
结论:
- 在ESUS患者的14天表面监视器中,整体AF检测率很低.
- 患有左心房尺寸扩大和/或 mitra 回吐的患者显示AF检测的可能性更高.
- 这些发现表明,患有这些特定心脏标志物的患者可能从初始短期监测中获益最多.
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