Prediction of functional outcome using the novel asymmetric middle cerebral artery index in cryptogenic stroke patients

Minho Han, Young Dae Kim, Hyung Jong Park, In Gun Hwang, Junghye Choi, Jimin Ha, Ji Hoe Heo, Hyo Suk Nam

Research output: Contribution to journalArticle

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Abstract

Background Etiology is unknown in approximately one-quarter of stroke patients after evaluation, which is termed cryptogenic stroke (CS). The prognosis of CS patients is largely undetermined. We created a novel index from transcranial Doppler parameters including mean flow velocity (MV) and pulsatility index (PI) and investigated whether the calculation of asymmetry in the novel parameter can predict functional outcomes in CS patients. Methods We made the middle cerebral artery (MCA) index (%) as a novel parameter, which was calculated as 100 X (MCA MV + MCA PI X 10) / (MCA MV–MCA PI X 10). The MCA asymmetry index (%) was also calculated as 100 X (|Rt MCA index–Lt MCA index|) / (Rt MCA index + Lt MCA index) / 2. Poor functional outcomes were defined as modified Rankin Scale score (mRS) 3 at 3 months after stroke onset. Results A total of 377 CS patients were included. Among them, 52 (13.8%) patients had a poor outcome. The overall MCA asymmetry index was two-fold higher in CS patients with a poor outcome (10.26%) compared to those with a good outcome (5.41%, p = 0.002). In multivariable analysis, the overall MCA asymmetry index (OR, 1.054, 95% CI, 1.013–1.096, p = 0.009) and the cutoff value of the overall MCA asymmetry index >9 were associated with poor outcomes at 3 months (OR, 3.737, 95% CI, 1.530–9.128, p = 0.004). Conclusion We demonstrated that the novel asymmetric MCA index can predict short-term functional outcomes in CS patients.

Original languageEnglish
Article numbere0208918
JournalPloS one
Volume14
Issue number1
DOIs
Publication statusPublished - 2019 Jan

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Middle Cerebral Artery
stroke
Flow velocity
arteries
Stroke
prediction
prognosis
etiology

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Han, Minho ; Kim, Young Dae ; Park, Hyung Jong ; Hwang, In Gun ; Choi, Junghye ; Ha, Jimin ; Heo, Ji Hoe ; Nam, Hyo Suk. / Prediction of functional outcome using the novel asymmetric middle cerebral artery index in cryptogenic stroke patients. In: PloS one. 2019 ; Vol. 14, No. 1.
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title = "Prediction of functional outcome using the novel asymmetric middle cerebral artery index in cryptogenic stroke patients",
abstract = "Background Etiology is unknown in approximately one-quarter of stroke patients after evaluation, which is termed cryptogenic stroke (CS). The prognosis of CS patients is largely undetermined. We created a novel index from transcranial Doppler parameters including mean flow velocity (MV) and pulsatility index (PI) and investigated whether the calculation of asymmetry in the novel parameter can predict functional outcomes in CS patients. Methods We made the middle cerebral artery (MCA) index ({\%}) as a novel parameter, which was calculated as 100 X (MCA MV + MCA PI X 10) / (MCA MV–MCA PI X 10). The MCA asymmetry index ({\%}) was also calculated as 100 X (|Rt MCA index–Lt MCA index|) / (Rt MCA index + Lt MCA index) / 2. Poor functional outcomes were defined as modified Rankin Scale score (mRS) 3 at 3 months after stroke onset. Results A total of 377 CS patients were included. Among them, 52 (13.8{\%}) patients had a poor outcome. The overall MCA asymmetry index was two-fold higher in CS patients with a poor outcome (10.26{\%}) compared to those with a good outcome (5.41{\%}, p = 0.002). In multivariable analysis, the overall MCA asymmetry index (OR, 1.054, 95{\%} CI, 1.013–1.096, p = 0.009) and the cutoff value of the overall MCA asymmetry index >9 were associated with poor outcomes at 3 months (OR, 3.737, 95{\%} CI, 1.530–9.128, p = 0.004). Conclusion We demonstrated that the novel asymmetric MCA index can predict short-term functional outcomes in CS patients.",
author = "Minho Han and Kim, {Young Dae} and Park, {Hyung Jong} and Hwang, {In Gun} and Junghye Choi and Jimin Ha and Heo, {Ji Hoe} and Nam, {Hyo Suk}",
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Prediction of functional outcome using the novel asymmetric middle cerebral artery index in cryptogenic stroke patients. / Han, Minho; Kim, Young Dae; Park, Hyung Jong; Hwang, In Gun; Choi, Junghye; Ha, Jimin; Heo, Ji Hoe; Nam, Hyo Suk.

In: PloS one, Vol. 14, No. 1, e0208918, 01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prediction of functional outcome using the novel asymmetric middle cerebral artery index in cryptogenic stroke patients

AU - Han, Minho

AU - Kim, Young Dae

AU - Park, Hyung Jong

AU - Hwang, In Gun

AU - Choi, Junghye

AU - Ha, Jimin

AU - Heo, Ji Hoe

AU - Nam, Hyo Suk

PY - 2019/1

Y1 - 2019/1

N2 - Background Etiology is unknown in approximately one-quarter of stroke patients after evaluation, which is termed cryptogenic stroke (CS). The prognosis of CS patients is largely undetermined. We created a novel index from transcranial Doppler parameters including mean flow velocity (MV) and pulsatility index (PI) and investigated whether the calculation of asymmetry in the novel parameter can predict functional outcomes in CS patients. Methods We made the middle cerebral artery (MCA) index (%) as a novel parameter, which was calculated as 100 X (MCA MV + MCA PI X 10) / (MCA MV–MCA PI X 10). The MCA asymmetry index (%) was also calculated as 100 X (|Rt MCA index–Lt MCA index|) / (Rt MCA index + Lt MCA index) / 2. Poor functional outcomes were defined as modified Rankin Scale score (mRS) 3 at 3 months after stroke onset. Results A total of 377 CS patients were included. Among them, 52 (13.8%) patients had a poor outcome. The overall MCA asymmetry index was two-fold higher in CS patients with a poor outcome (10.26%) compared to those with a good outcome (5.41%, p = 0.002). In multivariable analysis, the overall MCA asymmetry index (OR, 1.054, 95% CI, 1.013–1.096, p = 0.009) and the cutoff value of the overall MCA asymmetry index >9 were associated with poor outcomes at 3 months (OR, 3.737, 95% CI, 1.530–9.128, p = 0.004). Conclusion We demonstrated that the novel asymmetric MCA index can predict short-term functional outcomes in CS patients.

AB - Background Etiology is unknown in approximately one-quarter of stroke patients after evaluation, which is termed cryptogenic stroke (CS). The prognosis of CS patients is largely undetermined. We created a novel index from transcranial Doppler parameters including mean flow velocity (MV) and pulsatility index (PI) and investigated whether the calculation of asymmetry in the novel parameter can predict functional outcomes in CS patients. Methods We made the middle cerebral artery (MCA) index (%) as a novel parameter, which was calculated as 100 X (MCA MV + MCA PI X 10) / (MCA MV–MCA PI X 10). The MCA asymmetry index (%) was also calculated as 100 X (|Rt MCA index–Lt MCA index|) / (Rt MCA index + Lt MCA index) / 2. Poor functional outcomes were defined as modified Rankin Scale score (mRS) 3 at 3 months after stroke onset. Results A total of 377 CS patients were included. Among them, 52 (13.8%) patients had a poor outcome. The overall MCA asymmetry index was two-fold higher in CS patients with a poor outcome (10.26%) compared to those with a good outcome (5.41%, p = 0.002). In multivariable analysis, the overall MCA asymmetry index (OR, 1.054, 95% CI, 1.013–1.096, p = 0.009) and the cutoff value of the overall MCA asymmetry index >9 were associated with poor outcomes at 3 months (OR, 3.737, 95% CI, 1.530–9.128, p = 0.004). Conclusion We demonstrated that the novel asymmetric MCA index can predict short-term functional outcomes in CS patients.

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