Predictors of aortic complicated lesions in stroke patients.
Aortic complicated lesions (ACLs) should be associated with cerebral infarction. Our aim was to develop a simple clinical scale (ACL scale) to predict the presence of ACL. Consecutive stroke patients undergoing transesophageal echocardiogram (TEE) examination were prospectively enrolled. We defined ACL as the presence of >4 mm wall thickness, ulceration or mobile plaque in aortic arch. We also examined carotid intima-media thickness (IMT), ankle-brachial index (ABI) and brachial-ankle pulse-wave velocity (baPWV). We compared the clinical characteristics of patients with ACL (ACL group) and without ACL (non-ACL group), and devised a new ACL scale to predict the presence of ACL. In all, 165 patients (male 108, age 66.9 years) were enrolled and of these, 38% had ACL. The patients of the ACL group were older than those of the non-ACL group (73.0+/-10.2 vs. 63.1+/-13.6 years, P=0.001). Peripheral artery disease (PAD) was more frequent in the ACL group (18 vs. 4%, P=0.004). IMT was thicker in ACL group than in the non-ACL group (1.29+/-0.74 vs. 1.11+/-0.79 mm, P=0.002), and baPWV was higher in the ACL group (2164.2+/-643.2 vs. 1833.7+/-492.9 cm s(-1), P=0.001). We used three variables for determining the ACL scale score; (1) age >70, (2) presence of PAD and (3) smoking. The frequencies of ACL associated with ACL scale scores were as follows: 6% of patients with ACL scale score 0, 40% with score 1, 58% with score 2 and 100% with score 3. The ACL scale can predict the presence of aortic complicated lesions.
Terasawa
Yuka
Y
Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan. bbytera@gmail.com
Kimura
Kazumi
K
Iguchi
Yasuyuki
Y
Shibazaki
Kensaku
K
Okada
Yoko
Y
Matsumoto
Noriko
N
D000368:Aged; D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology; D015415:Biomarkers; D001772:Blood Cell Count; D015992:Body Mass Index; D002339:Carotid Arteries / Q000473:pathology; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*
D015415:Biomarkers