Ischemic lesion burden and characteristics of aortic atheroma

Jin-Man Jung, Joo Y. Kwon, Hye Jin Kim, Sun U. Kwon, Jae Kwan Song, Jong S. Kim, Dong Wha Kang

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: To investigate whether ischemic lesion burden including lesion pattern, number, and volume would vary depending on risk stratification of aortic atheroma (AA). Methods: Acute stroke patients were enrolled if they had (1) acute ischemic lesions on diffusion-weighted imaging within 5 days of symptom onset, (2) cardioembolic stroke established through extensive workup, and (3) only ascending or arch AA detected by transesophageal echocardiography as an embolic source. AA was classified as complex (protruding ≥4 mm into the aortic lumen or any mobile or ulcerative component) or simple (<4 mm). Results: Eighty-one patients (male: 65.4% and age: 66.7 ± 11.0 years) were included in the study. Thirty-four patients (41.9%) had complex atheroma. These patients had a greater number of ischemic lesions (median: 2 lesions [range: 1-42] versus one lesion [range: 1-27], P =.017) and a larger infarct size (9.01 cc [range: 3.58-49.14] versus 4.6 cc [range: 2.3-13.28), P =.056) than the simple atheroma group. Multivariable logistic regression analysis showed that ischemic lesion volume was independently associated with complex atheroma (odds ratio: 1.03, 95% confidence interval: 1.002-2.148, P =.035), while multiple lesions were related (odds ratio: 3.03, 95% confidence interval:.88-10.42, P =.079). Conclusions: Ischemic lesion burden in patients with AA differed according to AA characteristics, suggesting that the morphological features of AA could reflect an embolic potential of AA.

Original languageEnglish
Pages (from-to)278-282
Number of pages5
JournalJournal of Stroke and Cerebrovascular Diseases
Volume23
Issue number2
DOIs
Publication statusPublished - 2014 Feb 1

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Atherosclerotic Plaques
Stroke
Odds Ratio
Confidence Intervals
Transesophageal Echocardiography
Thoracic Aorta
Logistic Models
Regression Analysis

Keywords

  • aortic arch atherosclerosis
  • Ischemic stroke

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Ischemic lesion burden and characteristics of aortic atheroma. / Jung, Jin-Man; Kwon, Joo Y.; Kim, Hye Jin; Kwon, Sun U.; Song, Jae Kwan; Kim, Jong S.; Kang, Dong Wha.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 23, No. 2, 01.02.2014, p. 278-282.

Research output: Contribution to journalArticle

Jung, Jin-Man ; Kwon, Joo Y. ; Kim, Hye Jin ; Kwon, Sun U. ; Song, Jae Kwan ; Kim, Jong S. ; Kang, Dong Wha. / Ischemic lesion burden and characteristics of aortic atheroma. In: Journal of Stroke and Cerebrovascular Diseases. 2014 ; Vol. 23, No. 2. pp. 278-282.
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abstract = "Background: To investigate whether ischemic lesion burden including lesion pattern, number, and volume would vary depending on risk stratification of aortic atheroma (AA). Methods: Acute stroke patients were enrolled if they had (1) acute ischemic lesions on diffusion-weighted imaging within 5 days of symptom onset, (2) cardioembolic stroke established through extensive workup, and (3) only ascending or arch AA detected by transesophageal echocardiography as an embolic source. AA was classified as complex (protruding ≥4 mm into the aortic lumen or any mobile or ulcerative component) or simple (<4 mm). Results: Eighty-one patients (male: 65.4{\%} and age: 66.7 ± 11.0 years) were included in the study. Thirty-four patients (41.9{\%}) had complex atheroma. These patients had a greater number of ischemic lesions (median: 2 lesions [range: 1-42] versus one lesion [range: 1-27], P =.017) and a larger infarct size (9.01 cc [range: 3.58-49.14] versus 4.6 cc [range: 2.3-13.28), P =.056) than the simple atheroma group. Multivariable logistic regression analysis showed that ischemic lesion volume was independently associated with complex atheroma (odds ratio: 1.03, 95{\%} confidence interval: 1.002-2.148, P =.035), while multiple lesions were related (odds ratio: 3.03, 95{\%} confidence interval:.88-10.42, P =.079). Conclusions: Ischemic lesion burden in patients with AA differed according to AA characteristics, suggesting that the morphological features of AA could reflect an embolic potential of AA.",
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N2 - Background: To investigate whether ischemic lesion burden including lesion pattern, number, and volume would vary depending on risk stratification of aortic atheroma (AA). Methods: Acute stroke patients were enrolled if they had (1) acute ischemic lesions on diffusion-weighted imaging within 5 days of symptom onset, (2) cardioembolic stroke established through extensive workup, and (3) only ascending or arch AA detected by transesophageal echocardiography as an embolic source. AA was classified as complex (protruding ≥4 mm into the aortic lumen or any mobile or ulcerative component) or simple (<4 mm). Results: Eighty-one patients (male: 65.4% and age: 66.7 ± 11.0 years) were included in the study. Thirty-four patients (41.9%) had complex atheroma. These patients had a greater number of ischemic lesions (median: 2 lesions [range: 1-42] versus one lesion [range: 1-27], P =.017) and a larger infarct size (9.01 cc [range: 3.58-49.14] versus 4.6 cc [range: 2.3-13.28), P =.056) than the simple atheroma group. Multivariable logistic regression analysis showed that ischemic lesion volume was independently associated with complex atheroma (odds ratio: 1.03, 95% confidence interval: 1.002-2.148, P =.035), while multiple lesions were related (odds ratio: 3.03, 95% confidence interval:.88-10.42, P =.079). Conclusions: Ischemic lesion burden in patients with AA differed according to AA characteristics, suggesting that the morphological features of AA could reflect an embolic potential of AA.

AB - Background: To investigate whether ischemic lesion burden including lesion pattern, number, and volume would vary depending on risk stratification of aortic atheroma (AA). Methods: Acute stroke patients were enrolled if they had (1) acute ischemic lesions on diffusion-weighted imaging within 5 days of symptom onset, (2) cardioembolic stroke established through extensive workup, and (3) only ascending or arch AA detected by transesophageal echocardiography as an embolic source. AA was classified as complex (protruding ≥4 mm into the aortic lumen or any mobile or ulcerative component) or simple (<4 mm). Results: Eighty-one patients (male: 65.4% and age: 66.7 ± 11.0 years) were included in the study. Thirty-four patients (41.9%) had complex atheroma. These patients had a greater number of ischemic lesions (median: 2 lesions [range: 1-42] versus one lesion [range: 1-27], P =.017) and a larger infarct size (9.01 cc [range: 3.58-49.14] versus 4.6 cc [range: 2.3-13.28), P =.056) than the simple atheroma group. Multivariable logistic regression analysis showed that ischemic lesion volume was independently associated with complex atheroma (odds ratio: 1.03, 95% confidence interval: 1.002-2.148, P =.035), while multiple lesions were related (odds ratio: 3.03, 95% confidence interval:.88-10.42, P =.079). Conclusions: Ischemic lesion burden in patients with AA differed according to AA characteristics, suggesting that the morphological features of AA could reflect an embolic potential of AA.

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