Zhang Yanlei, Ye Zusen, Fu Yun, Zhang Zheng, Ye Qiang, Chen Feichi, Cheng Jianhua
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province 325000, People's Republic of China.
Department of Cardiac Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province 325000, People's Republic of China.
Neuropsychiatr Dis Treat. 2021 Jan 7;17:33-40. doi: 10.2147/NDT.S280641. eCollection 2021.
Cardiac myxoma is the most common primary cardiac tumor. Even though it rarely causes a stroke, it is an important risk factor. Here, we compared our clinical experience in managing myxoma patients who developed stroke complications with those who did not present with this condition at the First Affiliated Hospital of Wenzhou Medical University.
The medical records were reviewed of 160 cardiac myxoma patients who were treated in our facility from January 2006 to December 2019. They were separated into either a stroke group or non-stroke group.
Cardiac obstructive symptoms, embolic events and constitutional symptoms were observed in 92 (57.7%), 25 (15.6%) and 18 (11.2%) patients, respectively. Among 23 cardiac myxoma ischemic stroke patients, hypoesthesia (60.9%), hemiparesis (56.5%) and facial paresis (47.8%) were the three most common neurological symptoms. The middle cerebral artery (82.6%) was the most commonly affected vessel, whereas 73.9% of the ischemic patients had multiple stroke lesions. Binary logistic regression analysis showed that coronary heart disease and tumor sizes were independently associated in the stroke group (p <0.05). The 10 years cumulative survival rate was 87.9% for all patients after surgical intervention. There was no significant difference in the 10 years cumulative survival rate between the two groups (80.0% vs 88.9%, p =0.274 > 0.05).
The three most common neurological symptoms (hypoesthesia, hemiparesis and facial paresis), the middle cerebral artery and multiple lesions involvements were the definitive markers of patients afflicted with cardiac myxoma stroke. Small tumor sizes were independently associated with these patients. Surgical resection is a relatively safe procedure for treating both the stroke and non-stroke patients.
心脏黏液瘤是最常见的原发性心脏肿瘤。尽管它很少导致中风,但却是一个重要的危险因素。在此,我们比较了温州医科大学附属第一医院在处理出现中风并发症的黏液瘤患者与未出现该情况的黏液瘤患者方面的临床经验。
回顾了2006年1月至2019年12月在我院接受治疗的160例心脏黏液瘤患者的病历。他们被分为中风组或非中风组。
分别有92例(57.7%)、25例(15.6%)和18例(11.2%)患者出现心脏梗阻症状、栓塞事件和全身症状。在23例心脏黏液瘤缺血性中风患者中,感觉减退(60.9%)、偏瘫(56.5%)和面瘫(47.8%)是三种最常见的神经症状。大脑中动脉(82.6%)是最常受累的血管,而73.9%的缺血患者有多个中风病灶。二元逻辑回归分析显示,冠心病和肿瘤大小在中风组中独立相关(p<0.05)。手术干预后所有患者的10年累积生存率为87.9%。两组之间的10年累积生存率无显著差异(80.0%对88.9%,p = 0.274>0.05)。
三种最常见的神经症状(感觉减退、偏瘫和面瘫)、大脑中动脉以及多个病灶受累是患有心脏黏液瘤中风患者的明确标志。小肿瘤大小与这些患者独立相关。手术切除对于治疗中风和非中风患者都是相对安全的手术。