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缺血性卒中和短暂性脑缺血发作后的心脏影像学检查。

Cardiac Imaging After Ischemic Stroke or Transient Ischemic Attack.

机构信息

Clinic for Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany.

DZHK (German Center for Cardiovascular Research) (partner site Hamburg/Kiel/Luebeck), Berlin, Germany.

出版信息

Curr Neurol Neurosci Rep. 2020 Jun 30;20(8):36. doi: 10.1007/s11910-020-01053-3.

Abstract

PURPOSE OF REVIEW

Cardiac imaging after ischemic stroke or transient ischemic attack (TIA) is used to identify potential sources of cardioembolism, to classify stroke etiology leading to changes in secondary stroke prevention, and to detect frequent comorbidities. This article summarizes the latest research on this topic and provides an approach to clinical practice to use cardiac imaging after stroke.

RECENT FINDINGS

Echocardiography remains the primary imaging method for cardiac work-up after stroke. Recent echocardiography studies further demonstrated promising results regarding the prediction of non-permanent atrial fibrillation after ischemic stroke. Cardiac magnetic resonance imaging and computed tomography have been tested for their diagnostic value, in particular in patients with cryptogenic stroke, and can be considered as second line methods, providing complementary information in selected stroke patients. Cardiac imaging after ischemic stroke or TIA reveals a potential causal condition in a subset of patients. Whether systematic application of cardiac imaging improves outcome after stroke remains to be established.

摘要

目的综述

缺血性卒中和短暂性脑缺血发作(TIA)后的心脏影像学检查用于确定潜在的心源性栓塞源,对导致二级预防改变的卒中病因进行分类,并检测常见的合并症。本文总结了该主题的最新研究,并为临床实践中使用卒中后的心脏影像学检查提供了一种方法。

最新发现

超声心动图仍然是卒中后心脏检查的主要影像学方法。最近的超声心动图研究进一步证明了其在预测缺血性卒中非永久性心房颤动方面具有良好的效果。心脏磁共振成像和计算机断层扫描已被用于评估其诊断价值,特别是在隐源性卒中和 TIA 患者中,可以作为二线方法,为特定卒中患者提供补充信息。缺血性卒中和 TIA 后的心脏影像学检查揭示了一部分患者的潜在病因。系统应用心脏影像学检查是否能改善卒中后的结局仍有待确定。

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