title: Total Cerebral Blood Flow in Patients with Cardioembolic Stroke: Is It Clinically Meaningful?
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 CHA2DS2-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.
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain. Electronic address: jmarti@santpau.cat.
authors.forename: Joan
authors.initials: J
authors.lastname: Martí-Fàbregas
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
authors.forename: Sebastián
authors.initials: S
authors.lastname: Figueroa
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Martínez-Lizana
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
authors.forename: Irati
authors.initials: I
authors.lastname: Zubizarreta
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Carrera
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Martínez-Domeño
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Prats-Sánchez
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
authors.forename: Pol
authors.initials: P
authors.lastname: Camps-Renom
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Jiménez-Xarrié
authors.affiliation: Department of Neurology Stroke Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Barcelona, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Delgado-Mederos
mesh_terms: D000368:Aged; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D013923:Thromboembolism / Q000150:complications / Q000503:physiopathology*
keywords: Acute stroke; Atrial fibrillation; Cardiac embolism; Cerebral blood flow measurement; Neurosonology; Prognosis; Transcranial Doppler; Ultrasonography