Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, South Korea; Department of Neurology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
Department of Cardiology, Asan Medical Center, University of Ulsan, Seoul, South Korea.
J Stroke Cerebrovasc Dis. 2023 Apr;32(4):106999. doi: 10.1016/j.jstrokecerebrovasdis.2023.106999. Epub 2023 Jan 21.
Propensity for lesion lateralization in atrial fibrillation-related cardiac embolic stroke (AF-stroke) remains controversial. In this study, we compared the hemispheric differences among patients with AF-stroke and identified factors associated with lesion laterality.
We retrospectively reviewed patients with acute AF-stroke admitted from January, 2017 to March, 2022. Patients were grouped based on whether lesions were right or left hemispheric in the anterior circulation territory, based on diffusion-weighted imaging. Factors associated with right-side propensity were analyzed.
Among 385 patients, the mean age was 74±11 years and 52.5 % were male. Right and left hemispheric lesions were observed in 189 (49.1 %) and 196 (50.9%) patients, respectively. In the multivariate analysis, enlarged left atrium (LA) (adjusted odds ratio [aOR]=1.03, 95% confidential interval [CI], 1.007-1.061; p=0.013) and single confluent lesion pattern (aOR= 1.55, 95% CI, 1.012-2.381; p=0.044) were associated with right hemispheric lesions.
Enlarged LA and single confluent lesion pattern were strongly related to right-sided propensity in patients with AF-stroke.
心房颤动相关心源性脑栓塞（AF- stroke）的病灶侧偏倾向仍存在争议。本研究比较了 AF- stroke 患者的半球差异，并确定了与病灶侧偏相关的因素。
我们回顾性分析了 2017 年 1 月至 2022 年 3 月期间因急性 AF- stroke 入院的患者。根据弥散加权成像将患者分为前循环区域病灶位于右侧或左侧半球。分析与右侧倾向相关的因素。
在 385 例患者中，平均年龄为 74±11 岁，52.5%为男性。189 例（49.1%）和 196 例（50.9%）患者的右侧和左侧半球病变分别为右和左半球病变。多因素分析显示，左心房（LA）增大（调整比值比[aOR]=1.03，95%置信区间[CI]，1.007-1.061；p=0.013）和单一融合性病变模式（aOR=1.55，95%CI，1.012-2.381；p=0.044）与右侧半球病变相关。
LA 增大和单一融合性病变模式与 AF- stroke 患者的右侧倾向密切相关。
