Porebska Agata, Nowacki Przemyslaw, Safranow Krzysztof, Nowik Marta
Department of Neurology, University Hospital, Pomeranian Medical University of Szczecin, Unii Lubelskiej 1 Street, 71-252 Szczecin, Poland.
Clin Neurol Neurosurg. 2008 May;110(5):434-40. doi: 10.1016/j.clineuro.2007.12.007. Epub 2008 Feb 12.
The purpose of the present study was to evaluate whether blood flow in the middle cerebral arteries (MCAs) in patients with atrial fibrillation (AF) during acute ischemic stroke is disturbed, as well as to assess if potential disturbances result from arrhythmia rather than a consequence of an embolus within the cerebral circulation.
A total of 180 subjects were included in the study; 90 consecutive patients with AF and 90 consecutive patients in sinus rhythm who were admitted to the Stroke Unit of the Department of Neurology at Pomeranian Medical University Hospital in Szczecin, Poland within 24h of the onset of ischemic stroke symptoms. During the acute phase of the stroke (24h), all patients underwent transcranial Doppler ultrasonography (TCD) with assessment of mean blood flow velocity (MV) in the MCAs.
We observed significantly lower values of MV in MCAs of both damaged and intact hemispheres in patients with AF as compared to patients in sinus rhythm.
In patients with AF, hemodynamic disturbances occur within the cerebral circulation during acute ischemic stroke which can cause a more severe course and worse stroke outcome. AF patients need more appropriate prevention of stroke, as well as more efficient treatment during acute ischemic stroke.
本研究旨在评估急性缺血性卒中期间心房颤动（AF）患者大脑中动脉（MCA）的血流是否受到干扰，并评估潜在的干扰是由心律失常引起的，还是脑循环中栓子的结果。
本研究共纳入180名受试者；90名连续的AF患者和90名连续的窦性心律患者，他们在波兰什切青波美拉尼亚医科大学医院神经内科卒中单元在缺血性卒中症状发作后24小时内入院。在卒中急性期（24小时），所有患者均接受经颅多普勒超声检查（TCD），评估MCA的平均血流速度（MV）。
我们观察到，与窦性心律患者相比，AF患者受损半球和未受损半球MCA的MV值均显著降低。
在AF患者中，急性缺血性卒中期间脑循环中会出现血流动力学紊乱，这可能导致病情更严重、卒中结局更差。AF患者需要更适当的卒中预防，以及在急性缺血性卒中期间更有效的治疗。
