Finsterer Josef, Stollberger Claudia, Mölzer Günther, Winkler-Dworak Maria, Blazek Gerhard
Krankenanstalt Rudolfstiftung, Postfach 20, 1180 Vienna, Austria.
Int J Cardiol. 2008 Nov 28;130(3):344-8. doi: 10.1016/j.ijcard.2007.08.089. Epub 2008 Feb 21.
Little is known about frequency, morphology, and causes of stroke in patients with left-ventricular hypertrabeculation/noncompaction (LVHT). Aim of this study was to find out how many LVHT-patients suffer from stroke, which abnormalities are found on cerebral imaging, and if stroke LVHT-patients differ from non-stroke LVHT-patients with regard to cardiac and neuromuscular abnormalities.
Records of all included patients were reviewed for stroke diagnosed upon history, clinical examination, or cerebral CT/MRI (CCT, cMRI).
Among 104 LVHT-patients included, stroke was diagnosed in 16 (15%). Of these two had a transitory ischemic attack and one a prolonged ischemic deficit. Among 36 patients undergoing a CCT (n=32), cMRI (n=9), or both (n=5) territorial stroke was found in 7, lacunar stroke in 2, and intracerebral bleeding in 1. Other imaging findings were atrophy (n=7), microangiopathy (n=4), leucencephalopathy (n=3), basal-ganglia-calcification (n=2), or non-specific hypodensities (n=2). Imaging studies without vascular lesions were found in 2 patients. At least one classical risk factor for stroke was found in 15 patients. Stroke-patients did not differ from non-stroke-patients regarding cardiac or neuromuscular findings.
If systematically looked for, stroke is a frequent feature of LVHT. A causal relation between LVHT and stroke, however, is rather the exception than the rule.
关于左心室致密化不全(LVHT)患者中风的发生率、形态学及病因知之甚少。本研究的目的是了解有多少LVHT患者患有中风,脑部影像学检查发现了哪些异常,以及中风的LVHT患者在心脏和神经肌肉异常方面是否与非中风的LVHT患者存在差异。
对所有纳入患者的记录进行回顾,以确定根据病史、临床检查或脑部CT/MRI(CCT、cMRI)诊断的中风情况。
在纳入的104例LVHT患者中,16例(15%)被诊断为中风。其中2例发生短暂性脑缺血发作,1例出现持续性缺血性缺损。在36例接受CCT(n = 32)、cMRI(n = 9)或两者(n = 5)检查的患者中,发现7例为大面积中风,2例为腔隙性中风,1例为脑出血。其他影像学表现包括萎缩(n = 7)、微血管病(n = 4)、白质脑病(n = 3)、基底节钙化(n = 2)或非特异性低密度影(n = 2)。2例患者的影像学检查未发现血管病变。15例患者至少有一项经典的中风危险因素。中风患者与非中风患者在心脏或神经肌肉检查结果方面无差异。
如果进行系统筛查,中风是LVHT的常见特征。然而,LVHT与中风之间的因果关系实属罕见,而非普遍规律。