Different infarction patterns in patients with aortic atheroma compared to those with cardioembolism or large artery atherosclerosis

Seung Woo Kim, Young Dae Kim, Hyuk Jae Chang, Geu Ru Hong, Chi Young Shim, Seok Jong Chung, Jin Yong Hong, Tae Jin Song, Dongbeom Song, Oh Young Bang, Ji Hoe Heo, Hyo Suk Nam

Research output: Contribution to journalArticle

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Abstract

Aortic atheroma is a known cause of ischemic stroke. However, it is unclear whether ischemic stroke is caused by emboli from aortic atheroma or by accompanying atherosclerosis. In this study, we evaluated lesion patterns of patients with complex aortic plaque (CAP) to assume the underlying pathophysiology. Acute ischemic stroke patients who underwent transesophageal echocardiography were included. CAP was defined as a plaque in the proximal aorta ≥ 4 mm thick or with a mobile component. The diffusion-weighted imaging lesion patterns of patients with CAP were compared to those with large arterial atherosclerosis (LAA) or cardioembolism (CE). A total of 64 CAP patients, 127 LAA patients, and 80 CE patients were included. Small cortical pattern was more common in the CAP group (45.3%) than in the LAA (7.9%, p < 0.001) or the CE group (23.8%, p = 0.018). A large cortical pattern was more common in the CE group than in the CAP group (p < 0.001), whereas subcortical only pattern tended to be more common in the CAP group than in the CE group (p = 0.057). In multinominal analysis, the CAP group was more likely to have a small cortical lesion than the LAA group [odds ratio (OR) 14.63; 95% confidence interval (CI) 4.67–45.85] or the CE (OR 3.69, 95% CI 1.19–11.39) group. In conclusion, patients with CAP frequently had small cortical lesions or subcortical single lesion. These findings imply that ischemic stroke in aortic atheroma patients is associated with either small emboli or small artery disease.

Original languageEnglish
Pages (from-to)151-158
Number of pages8
JournalJournal of Neurology
Volume265
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

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Atherosclerotic Plaques
Infarction
Atherosclerosis
Arteries
Stroke
Embolism
Odds Ratio
Confidence Intervals
Transesophageal Echocardiography
Aorta

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Kim, Seung Woo ; Kim, Young Dae ; Chang, Hyuk Jae ; Hong, Geu Ru ; Shim, Chi Young ; Chung, Seok Jong ; Hong, Jin Yong ; Song, Tae Jin ; Song, Dongbeom ; Bang, Oh Young ; Heo, Ji Hoe ; Nam, Hyo Suk. / Different infarction patterns in patients with aortic atheroma compared to those with cardioembolism or large artery atherosclerosis. In: Journal of Neurology. 2018 ; Vol. 265, No. 1. pp. 151-158.
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abstract = "Aortic atheroma is a known cause of ischemic stroke. However, it is unclear whether ischemic stroke is caused by emboli from aortic atheroma or by accompanying atherosclerosis. In this study, we evaluated lesion patterns of patients with complex aortic plaque (CAP) to assume the underlying pathophysiology. Acute ischemic stroke patients who underwent transesophageal echocardiography were included. CAP was defined as a plaque in the proximal aorta ≥ 4 mm thick or with a mobile component. The diffusion-weighted imaging lesion patterns of patients with CAP were compared to those with large arterial atherosclerosis (LAA) or cardioembolism (CE). A total of 64 CAP patients, 127 LAA patients, and 80 CE patients were included. Small cortical pattern was more common in the CAP group (45.3{\%}) than in the LAA (7.9{\%}, p < 0.001) or the CE group (23.8{\%}, p = 0.018). A large cortical pattern was more common in the CE group than in the CAP group (p < 0.001), whereas subcortical only pattern tended to be more common in the CAP group than in the CE group (p = 0.057). In multinominal analysis, the CAP group was more likely to have a small cortical lesion than the LAA group [odds ratio (OR) 14.63; 95{\%} confidence interval (CI) 4.67–45.85] or the CE (OR 3.69, 95{\%} CI 1.19–11.39) group. In conclusion, patients with CAP frequently had small cortical lesions or subcortical single lesion. These findings imply that ischemic stroke in aortic atheroma patients is associated with either small emboli or small artery disease.",
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Different infarction patterns in patients with aortic atheroma compared to those with cardioembolism or large artery atherosclerosis. / Kim, Seung Woo; Kim, Young Dae; Chang, Hyuk Jae; Hong, Geu Ru; Shim, Chi Young; Chung, Seok Jong; Hong, Jin Yong; Song, Tae Jin; Song, Dongbeom; Bang, Oh Young; Heo, Ji Hoe; Nam, Hyo Suk.

In: Journal of Neurology, Vol. 265, No. 1, 01.01.2018, p. 151-158.

Research output: Contribution to journalArticle

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AU - Kim, Young Dae

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AU - Chung, Seok Jong

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AU - Song, Tae Jin

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AU - Heo, Ji Hoe

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