伴有左心房扩大的急性缺血性中风患者的特定炎症特征。
Specific inflammatory profile of acute ischemic stroke patients with left atrial enlargement.
作者信息
Fontaine Julia, Leboube Simon, Bochaton Thomas, Thibault Hélène, Amaz Camille, Cho Tae-Hee, Paccalet Alexandre, Crola Da Silva Claire, Duhamel Suzanne, Buisson Marielle, Rascle Lucie, Bidaux Gabriel, Ovize Michel, Nighoghossian Norbert, Mechtouff Laura
机构信息
Stroke Department, Hospices Civils de Lyon, Bron, France.
Univ-Lyon, CarMeN Laboratory, Inserm U1060/INRA U1397, Université Claude Bernard Lyon 1, Lyon, France.
出版信息
Front Cardiovasc Med. 2023 Jul 19;10:1190857. doi: 10.3389/fcvm.2023.1190857. eCollection 2023.
BACKGROUND
The inflammatory process underlying atrial myopathy may affect the inflammatory response activated in acute ischemic stroke (AIS).
OBJECTIVES
We aimed to assess whether left atrial enlargement (LAE) as a marker of atrial myopathy is associated with a different profile of circulating inflammatory markers in AIS patients.
METHODS
HIBISCUS-STROKE is a cohort study including anterior circulation AIS patients treated with mechanical thrombectomy following MRI. Ten circulating inflammatory markers were measured at admission and 6, 24, and 48 h after admission. LAE was defined as a left atrial volume index (LAVi) ≥34 ml/m. A multiple logistic regression model was performed to detect an independent association between the area under the curve (AUC) of these markers and LAE.
RESULTS
We included 143 patients. Of them, 85 (59.4%) had LAE. On univariable analysis, we found that patients with LAE had higher soluble form suppression of tumorigenicity 2 (sST2), soluble tumor necrosis factor receptor I (sTNFR1), and vascular cellular adhesion molecule-1 (VCAM-1) AUC, were older, mostly female, had a higher National Institutes of Health Stroke Scale (NIHSS) score and blood glucose level at admission, had more often hypertension, and a cardioembolic source of AIS, such as atrial fibrillation, while they were less frequently current smokers and had a lower rate of tandem occlusion than patients without LAE. On multivariable analysis, we found that among circulating inflammatory markers, only high VCAM-1 (OR: 9.13, 95% CI: 3.21-25.9) and sST2 (OR: 3.40, 95% CI: 1.68-6.86) AUC remained associated with LAE.
CONCLUSIONS
High VCAM-1 and sST2 levels within the first 48 h are associated with LAE in AIS patients.
背景
心房肌病潜在的炎症过程可能会影响急性缺血性卒中（AIS）中激活的炎症反应。
目的
我们旨在评估作为心房肌病标志物的左心房扩大（LAE）是否与AIS患者循环炎症标志物的不同特征相关。
方法
HIBISCUS - 卒中是一项队列研究，纳入了MRI检查后接受机械取栓治疗的前循环AIS患者。在入院时以及入院后6、24和48小时测量10种循环炎症标志物。LAE定义为左心房容积指数（LAVi）≥34 ml/m²。进行多因素逻辑回归模型以检测这些标志物的曲线下面积（AUC）与LAE之间的独立关联。
结果
我们纳入了143例患者。其中，85例（59.4%）有LAE。单因素分析显示，有LAE的患者可溶性肿瘤生长抑制因子2（sST2）、可溶性肿瘤坏死因子受体I（sTNFR1）和血管细胞黏附分子 - 1（VCAM - 1）的AUC更高，年龄更大，多数为女性，入院时美国国立卫生研究院卒中量表（NIHSS）评分和血糖水平更高，高血压、AIS的心源性栓塞来源（如心房颤动）更为常见，而当前吸烟者较少，串联闭塞率低于无LAE的患者。多因素分析显示，在循环炎症标志物中，只有高VCAM - 1（比值比：9.13，95%置信区间：3.21 - 25.9）和sST2（比值比：3.40，95%置信区间：1.68 - 6.86）的AUC仍与LAE相关。
结论
AIS患者在最初48小时内高VCAM - 1和sST2水平与LAE相关。
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