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Verfasst von:Rizos, Timolaos [VerfasserIn]   i
 Bartsch, Andreas J. [VerfasserIn]   i
 Dittgen, Felix [VerfasserIn]   i
 Veltkamp, Roland [VerfasserIn]   i
Titel:Voxelwise distribution of acute ischemic stroke lesions in patients with newly diagnosed atrial fibrillation
Titelzusatz:trigger of arrhythmia or only target of embolism?
Verf.angabe:Timolaos Rizos, Andreas J. Bartsch, Timothy D. Johnson, Felix Dittgen, Thomas E. Nichols, Uwe Malzahn, Roland Veltkamp
E-Jahr:2017
Jahr:24 May 2017
Fussnoten:Gesehen am 05.07.2018
Titel Quelle:Enthalten in: PLOS ONE
Ort Quelle:San Francisco, California, US : PLOS, 2006
Jahr Quelle:2017
Band/Heft Quelle:12(2017,5) Artikel-Nummer e0177474, 17 Seiten
ISSN Quelle:1932-6203
Abstract:Objective Atrial fibrillation (AF) is frequently detected after ischemic stroke for the first time, and brain regions involved in autonomic control have been suspected to trigger AF. We examined whether specific brain regions are associated with newly detected AF after ischemic stroke. Methods Patients with acute cerebral infarctions on diffusion-weighted magnetic resonance imaging were included in this lesion mapping study. Lesions were mapped and modeled voxelwise using Bayesian Spatial Generalised Linear Mixed Modeling to determine differences in infarct locations between stroke patients with new AF, without AF and with AF already known before the stroke. Results 582 patients were included (median age 68 years; 63.2% male). AF was present in 109/582 patients [(18.7%); new AF: 39/109 (35.8%), known AF: 70/109 (64.2%)]. AF patients had larger infarct volumes than patients without AF (mean: 29.7 ± 45.8 ml vs. 15.2 ± 35.1 ml; p<0.001). Lesions in AF patients accumulated in the right central middle cerebral artery territory. Increasing stroke size predicted progressive cortical but not pontine and thalamic involvement. Patients with new AF had more frequently lesions in the right insula compared to patients without AF when stroke size was not accounted for, but no specific brain region was more frequently involved after adjustment for infarct volume. Controlled for stroke size, left parietal involvement was less likely for patients with new AF than for those without AF or with known AF. Conclusions In the search for brain areas potentially triggering cardiac arrhythmias infarct size should be accounted for. After controlling for infarct size, there is currently no evidence that ischemic stroke lesions of specific brain areas are associated with new AF compared to patients without AF. This challenges the neurogenic hypothesis of AF according to which a relevant proportion of new AF is triggered by ischemic brain lesions of particular locations.
DOI:doi:10.1371/journal.pone.0177474
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

kostenfrei: Volltext: http://dx.doi.org/10.1371/journal.pone.0177474
 kostenfrei: Volltext: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0177474
 DOI: https://doi.org/10.1371/journal.pone.0177474
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Arrhythmia
 Atrial fibrillation
 Cerebral arteries
 Cerebral ischemia
 Ischemic stroke
 Lesions
 Magnetic resonance imaging
 Stroke
K10plus-PPN:1577319303
Verknüpfungen:→ Zeitschrift

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