title: IRMA study: Prevalence of subdiaphragmatic visceral infarction in ischemic stroke and atrial fibrillation.
abstract: Background Occult atrial fibrillation (AF) may, in part, explain cryptogenic stroke. A 22% prevalence of subdiaphragmatic visceral infarction (SDVI) among patients with ischemic stroke (IS) due to AF has been reported, using abdominal MRI. We sought to assess the reproducibility of this method and to confirm that SDVI is more prevalent in cases of AF-caused IS than in IS of other etiologies. Methods In consecutive patients admitted to our hospital, we compared SDVI prevalence in three groups: patients with IS due to AF (IS+/AF+ group), patients with stroke of another determined cause (IS+/AF- group) and patients with AF without stroke (IS-/AF+ group). Results A total of 111 patients were included. The median time between inclusion and abdominal MRI was six days. SDVI was more frequent in the IS+/AF+ group ( n = 10; 21.3%), than in IS+/AF- ( n = 1; 3.3%) and IS-/AF+ ( n = 0) groups, p = 0.002. The most frequent localization was the kidney. Conclusions The prevalence of SDVI was higher among patients with AF-caused IS. In cases of cryptogenic stroke, a positive abdominal MRI may suggest occult AF as the cause and identify a high risk of AF in this subgroup of patients.
authors.affiliation: 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France.
authors.forename: David
authors.initials: D
authors.lastname: Weisenburger-Lile
authors.affiliation: 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Lopez
authors.affiliation: 2 Department of Cardiology, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Russel
authors.affiliation: 3 Department of Internal Medicine, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France.
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: Kahn
authors.affiliation: 4 Department of Geriatrics, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France.
authors.forename: Ana
authors.initials: A
authors.lastname: Veiga Hellmann
authors.affiliation: 5 Department of Radiology, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Scherrer
authors.affiliation: 6 Department of Biostatistics, Univ. Lille, épidémiologie et qualité des soins, Lille, France.
authors.forename: Nassima
authors.initials: N
authors.lastname: Ramdane
authors.affiliation: 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Wang
authors.affiliation: 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Evrard
authors.affiliation: 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Decroix
authors.affiliation: 5 Department of Radiology, Foch Hospital and Versailles Saint-Quentin en Yvelines University, Suresnes, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Mellot
authors.affiliation: 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Bourdain
authors.affiliation: 1 Department of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lapergue
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000628:therapy; D013997:Time Factors
keywords: MRI; Stroke; atrial fibrillation; ischemic stroke; stroke subtypes; subdiaphragmatic visceral infarction