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    난원공개존증과 심방 세동 환자의 뇌경색 용적과 초기 신경학적 결손 비교 = Difference in Infarct Volume and Initial Clinical Severity between Stroke Patient with Patent Foramen Ovale and Atrial Fibrillation

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    https://www.riss.kr/link?id=A101607791

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    다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

    Background: Atrial fi brillation (AF) and patent foramen ovale (PFO) are established sources of cardioembolism. We investigated differences in stroke outcome and patterns between PFO and AF. Methods: We performed a retrospective review of the medical records and brain MR images of patients with AF or PFO from the prospective acute stroke and transient ischemic attack registry. Infarct pattern and volume on diffusion-weighted imaging, and the national institutes of health stroke scale (NIHSS)on admission were compared between patients with AF and PFO. Results: From June 2005 to July 2008, a total of 289 subjects were enrolled (AF group, n=156; PFO group, n=133). Infarct pattern analyzed with MR images revealed that multiple vascular territorial infarction was more prevalent in AF group than in PFO group (26.9% vs. 8.3%, P <0.01). A probable cardiac embolism,radiologically defi ned as territorial infarction without symptomatic steno-occlusion of the corresponding artery, was more frequently documented in AF group than in PFO group (71.8% vs. 41.4%, P <0.01) The infarct volume of PFO was smaller than that of AF. Compared to AF, PFO was associated with the mild neurologic defi cit (NIHSS≤3) after adjusting age, sex and previous stroke history. Conclusion: These results suggested that AF and PFO had different characteristics such as infarct patterns and initial clinical severity although both are classifi ed as cardioembolism.
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    Background: Atrial fi brillation (AF) and patent foramen ovale (PFO) are established sources of cardioembolism. We investigated differences in stroke outcome and patterns between PFO and AF. Methods: We performed a retrospective review of the medical ...

    Background: Atrial fi brillation (AF) and patent foramen ovale (PFO) are established sources of cardioembolism. We investigated differences in stroke outcome and patterns between PFO and AF. Methods: We performed a retrospective review of the medical records and brain MR images of patients with AF or PFO from the prospective acute stroke and transient ischemic attack registry. Infarct pattern and volume on diffusion-weighted imaging, and the national institutes of health stroke scale (NIHSS)on admission were compared between patients with AF and PFO. Results: From June 2005 to July 2008, a total of 289 subjects were enrolled (AF group, n=156; PFO group, n=133). Infarct pattern analyzed with MR images revealed that multiple vascular territorial infarction was more prevalent in AF group than in PFO group (26.9% vs. 8.3%, P <0.01). A probable cardiac embolism,radiologically defi ned as territorial infarction without symptomatic steno-occlusion of the corresponding artery, was more frequently documented in AF group than in PFO group (71.8% vs. 41.4%, P <0.01) The infarct volume of PFO was smaller than that of AF. Compared to AF, PFO was associated with the mild neurologic defi cit (NIHSS≤3) after adjusting age, sex and previous stroke history. Conclusion: These results suggested that AF and PFO had different characteristics such as infarct patterns and initial clinical severity although both are classifi ed as cardioembolism.

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    참고문헌 (Reference)

    1 Medi C, "Stroke risk and antithrombotic strategies in atrial fi brillation" 41 : 2705-2713, 2010

    2 박희권, "Small deep white matter lesions are associated with right-to-left shunts in migraineurs" DR DIETRICH STEINKOPFF VERLAG 258 (258): 427-433, 201103

    3 Thaler DE, "Rethinking trial strategies for stroke and patent foramen ovale" 23 : 73-78, 2010

    4 Mas JL, "Recurrent cerebrovascular events in patients with patent foramen ovale, atrial septal aneurysm, or both and cryptogenic stroke or transient ischemic attack. French study group on patent foramen ovale and atrial septal aneurysm" 130 : 1083-1088, 1995

    5 Lechat P, "Prevalence of patent foramen ovale in patients with stroke" 318 : 1148-1152, 1988

    6 Messe SR, "Practice parameter: Recurrent stroke with patent foramen ovale and atrial septal aneurysm: Report of the quality standards subcommittee of the american academy of neurology" 62 : 1042-1050, 2004

    7 Adams HP Jr., "Patent foramen ovale: Paradoxical embolism and paradoxical data" 79 : 15-20, 2004

    8 Steiner MM, "Patent foramen ovale size and embolic brain imaging fi ndings among patients with ischemic stroke" 29 : 944-948, 1998

    9 Handke M, "Patent foramen ovale and cryptogenic stroke in older patients" 357 : 2262-2268, 2007

    10 Desai AJ, "Patent foramen ovale and cerebrovascular diseases" 6 : 446-455, 2006

    1 Medi C, "Stroke risk and antithrombotic strategies in atrial fi brillation" 41 : 2705-2713, 2010

    2 박희권, "Small deep white matter lesions are associated with right-to-left shunts in migraineurs" DR DIETRICH STEINKOPFF VERLAG 258 (258): 427-433, 201103

    3 Thaler DE, "Rethinking trial strategies for stroke and patent foramen ovale" 23 : 73-78, 2010

    4 Mas JL, "Recurrent cerebrovascular events in patients with patent foramen ovale, atrial septal aneurysm, or both and cryptogenic stroke or transient ischemic attack. French study group on patent foramen ovale and atrial septal aneurysm" 130 : 1083-1088, 1995

    5 Lechat P, "Prevalence of patent foramen ovale in patients with stroke" 318 : 1148-1152, 1988

    6 Messe SR, "Practice parameter: Recurrent stroke with patent foramen ovale and atrial septal aneurysm: Report of the quality standards subcommittee of the american academy of neurology" 62 : 1042-1050, 2004

    7 Adams HP Jr., "Patent foramen ovale: Paradoxical embolism and paradoxical data" 79 : 15-20, 2004

    8 Steiner MM, "Patent foramen ovale size and embolic brain imaging fi ndings among patients with ischemic stroke" 29 : 944-948, 1998

    9 Handke M, "Patent foramen ovale and cryptogenic stroke in older patients" 357 : 2262-2268, 2007

    10 Desai AJ, "Patent foramen ovale and cerebrovascular diseases" 6 : 446-455, 2006

    11 Overell JR, "Interatrial septal abnormalities and stroke: A meta-analysis of case-control studies" 55 : 1172-1179, 2000

    12 Tanizaki Y, "Incidence and risk factors for subtypes of cerebral infarction in a general population: The hisayama study" 31 : 2616-2622, 2000

    13 Tanislav C, "High frequency of silent pulmonary embolism in patients with cryptogenic stroke and patent foramen ovale" 42 : 822-824, 2011

    14 Han SW, "Frequency and signifi cance of cardiac sources of embolism in the toast classifi - cation" 24 : 463-468, 2007

    15 Homma S, "Effect of medical treatment in stroke patients with patent foramen ovale: Patent foramen ovale in cryptogenic stroke study" 105 : 2625-2631, 2002

    16 Timsit S, "Cryptogenic cerebral infarction: From classifi - cation to concept" 38 : 1832-1842, 2009

    17 Lamy C, "Clinical and imaging fi ndings in cryptogenic stroke patients with and without patent foramen ovale: The PFO-ASA study. Atrial Septal Aneurysm" 33 : 706-711, 2002

    18 Adams HP Jr, "Classifi cation of subtype of acute ischemic stroke. Defi nitions for use in a multicenter clinical trial. Toast. Trial of org 10172 in Acute Stroke Treatment" 24 : 35-41, 1993

    19 Hart RG, "Atrial fibrillation and stroke: Concepts and controversies" 32 : 803-808, 2001

    20 Cohen A, "Aortic plaque morphology and vascular events: A follow-up study in patients with ischemic stroke. FAPS investigators. French study of aortic plaques in stroke" 96 : 3838-3841, 1997

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