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Analyze the Characteristic of Risk Factors and Imaging in Ischemic Stroke Patients with Non Valvular Atrial Fibrillation with Cerebral Arterial Stenosis

Author: SunWei
Tutor: LiGuangSheng
School:
Course: Neurology
Keywords: Non valvular atrial fibrillation Ischemic stroke Cerebral arterialstenosis Risk factors CHADS2score DW imaging Pathogenesis
CLC: R743.33
Type: Master's thesis
Year: 2013
Downloads: 4
Quote: 0
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Abstract


Objective:The aim of this study was to determine wether there are difference inthe risk factors and ischemic lesions on Diffusion-weighted(DW) MR imaging withischemic stroke patients with Non valvular atrial fibrillation(NVAF) with cerebralarterial stenosis and without cerebral arterial stenosis,as well as investigated thestroke mechanism which may be cerebral atherosclerosis.Methods:We included73consecutive ischemic stroke patients with NVAF inGanzhou city People’s Hospital between December2011and March2012.All patientswere divided2groups:43ischemic stroke patients with NVAF with cerebral arterialstenosis(cerebral arterial stenosis group) and30ischemic stroke patients with NVAFwithout cerebral arterial stenosis(non cerebral arterial stenosis group).The clinicalcharacteristics(such as age, sex, NIHSS score, CHADS2score, history of stroke ortransient ischemic attack TIA,history of coronary heart disease, hypertension,diabetes mellitus,heart failure etc),assistant examination(such as total cholesterol,triglycerides,low-density lipoprotein,fibrinogen, homocysteine, diameter of leftatrium, ejection fraction) and ischemic lesion patterns of cerebral arterial stenosisgroups and non cerebral arterial stenosis groups were analyzed.Results:Cerebral arterial stenosis group were significantly increased inage(P<0.01),NIHSS score(P<0.01) and CHADS2score(P<0.01),and more likely tohave a history of stroke or TIA(P<0.01) and hypertension(P<0.01).There was apositive correlation between the CHADS2score and the number of arteries affectedby concomitant cerebral atherosclerosis（r=0.716,P=0.000）.The ischemic lesions onDW imaging of cerebral arterial stenosis group were various such as multiplelesions,large lesion,watershed infarction and lacunar infarction.The percentage ofmultiple ischemic lesions on DW imaging in non cerebral arterial stenosis group wassignificantly higer than cerebral arterial stenosis group(60.0%vs26.2%,P<0.05).Conclusions:The risk factors such as older age,hypertension and a history ofstroke or TIA were closely related to the ischemic stroke patients with NVAF with cerebral arterial stenosis,and there was a correlation between the CHADS2score andthe seriousness of cerebral arterial stenosis. There may be multiple pathogenesis ofischemic stroke patients with NVAF with cerebral arterial stenosis,which was notonly cardiogenic embolism but also cerebral atherosclerosis.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke) > Cerebral embolism
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