Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study
Abstract Introduction The presence of microembolic signals (MES) during the acute phase of stroke is poorly understood, and its role and clinical application in relation to risk stratification and prognosis in patients remain uncertain. We assessed the prevalence of spontaneous MES in acute stroke a...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2020-02-01
|
| Series: | The Ultrasound Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13089-020-0156-1 |
| _version_ | 1819178280296644608 |
|---|---|
| author | Rodrigo Bazan Gustavo José Luvizutto Gabriel Pereira Braga Silméia Garcia Zanati Bazan João Carlos Hueb Carlos Clayton Macedo de Freitas Pedro Tadao Hamamoto Filho Gabriel Pinheiro Módolo André Petean Trindade Marcone Lima Sobreira Hélio Rubens de Carvalho Nunes João Pereira Leite Octávio Marques Pontes-Neto |
| author_facet | Rodrigo Bazan Gustavo José Luvizutto Gabriel Pereira Braga Silméia Garcia Zanati Bazan João Carlos Hueb Carlos Clayton Macedo de Freitas Pedro Tadao Hamamoto Filho Gabriel Pinheiro Módolo André Petean Trindade Marcone Lima Sobreira Hélio Rubens de Carvalho Nunes João Pereira Leite Octávio Marques Pontes-Neto |
| author_sort | Rodrigo Bazan |
| collection | DOAJ |
| description | Abstract Introduction The presence of microembolic signals (MES) during the acute phase of stroke is poorly understood, and its role and clinical application in relation to risk stratification and prognosis in patients remain uncertain. We assessed the prevalence of spontaneous MES in acute stroke and their relationship with risk stratification, stroke recurrence, morbidity, and mortality. Patients and methods This was a prospective cohort study conducted in the Stroke Unit. The MES presence was evaluated by transcranial Doppler (TCD) in patients with ischemic stroke within 48 h. The outcomes (risk stratification, morbidity, mortality, and recurrence of a stroke) were followed up for 6 months. The relationship between risk stratification and MES was obtained by odds ratios and that between MES and stroke recurrence, morbidity, and mortality using multiple logistic regression; considering statistical significance at P < 0.05. Results Of the 111 patients studied, 70 were men (63.1%) and 90 were white (81.1%), with a median age of 68 years. The MES frequency was 7%. There was a significant relationship between MES and symptomatic carotid disease (OR = 22.7; 95% CI 4.1–125.7; P < 0.001), a shorter time to monitoring (OR = 12.4; 95% CI 1.4–105.4; P = 0.02), and stroke recurrence (OR = 16.83; 95% CI 2.01–141; P = .009). Discussion It was observed that the stroke recurrence adjusted for prior stroke was higher and earlier among patients with MES detection. In conclusion, MES demonstrated a significant correlation with symptomatic carotid disease and a shorter DELAY until monitoring, and could be a predictor for the early recurrence of stroke in the long term. |
| first_indexed | 2024-12-22T21:40:02Z |
| format | Article |
| id | doaj.art-a8fa549af5e243e085afe7b0c4c87de6 |
| institution | Directory Open Access Journal |
| issn | 2524-8987 |
| language | English |
| last_indexed | 2024-12-22T21:40:02Z |
| publishDate | 2020-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Ultrasound Journal |
| spelling | doaj.art-a8fa549af5e243e085afe7b0c4c87de62022-12-21T18:11:39ZengSpringerOpenThe Ultrasound Journal2524-89872020-02-0112111210.1186/s13089-020-0156-1Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective studyRodrigo Bazan0Gustavo José Luvizutto1Gabriel Pereira Braga2Silméia Garcia Zanati Bazan3João Carlos Hueb4Carlos Clayton Macedo de Freitas5Pedro Tadao Hamamoto Filho6Gabriel Pinheiro Módolo7André Petean Trindade8Marcone Lima Sobreira9Hélio Rubens de Carvalho Nunes10João Pereira Leite11Octávio Marques Pontes-Neto12Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Applied Physical Therapy, Institute of Health Sciences, UFTM–Univ Federal do Triângulo MineiroDepartment of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Internal Medicine, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Internal Medicine, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Tropical Diseases and Imaging Diagnosis, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Surgery and Orthopedics, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP–Univ Estadual PaulistaDepartment of Neuroscience and Behavior, Ribeirão Preto School of Medicine, USP–Univ São PauloDepartment of Neuroscience and Behavior, Ribeirão Preto School of Medicine, USP–Univ São PauloAbstract Introduction The presence of microembolic signals (MES) during the acute phase of stroke is poorly understood, and its role and clinical application in relation to risk stratification and prognosis in patients remain uncertain. We assessed the prevalence of spontaneous MES in acute stroke and their relationship with risk stratification, stroke recurrence, morbidity, and mortality. Patients and methods This was a prospective cohort study conducted in the Stroke Unit. The MES presence was evaluated by transcranial Doppler (TCD) in patients with ischemic stroke within 48 h. The outcomes (risk stratification, morbidity, mortality, and recurrence of a stroke) were followed up for 6 months. The relationship between risk stratification and MES was obtained by odds ratios and that between MES and stroke recurrence, morbidity, and mortality using multiple logistic regression; considering statistical significance at P < 0.05. Results Of the 111 patients studied, 70 were men (63.1%) and 90 were white (81.1%), with a median age of 68 years. The MES frequency was 7%. There was a significant relationship between MES and symptomatic carotid disease (OR = 22.7; 95% CI 4.1–125.7; P < 0.001), a shorter time to monitoring (OR = 12.4; 95% CI 1.4–105.4; P = 0.02), and stroke recurrence (OR = 16.83; 95% CI 2.01–141; P = .009). Discussion It was observed that the stroke recurrence adjusted for prior stroke was higher and earlier among patients with MES detection. In conclusion, MES demonstrated a significant correlation with symptomatic carotid disease and a shorter DELAY until monitoring, and could be a predictor for the early recurrence of stroke in the long term.https://doi.org/10.1186/s13089-020-0156-1Brain embolismPrognosisRisk factorsStrokeTranscranial Doppler ultrasonography |
| spellingShingle | Rodrigo Bazan Gustavo José Luvizutto Gabriel Pereira Braga Silméia Garcia Zanati Bazan João Carlos Hueb Carlos Clayton Macedo de Freitas Pedro Tadao Hamamoto Filho Gabriel Pinheiro Módolo André Petean Trindade Marcone Lima Sobreira Hélio Rubens de Carvalho Nunes João Pereira Leite Octávio Marques Pontes-Neto Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study The Ultrasound Journal Brain embolism Prognosis Risk factors Stroke Transcranial Doppler ultrasonography |
| title | Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
| title_full | Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
| title_fullStr | Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
| title_full_unstemmed | Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
| title_short | Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study |
| title_sort | relationship of spontaneous microembolic signals to risk stratification recurrence severity and mortality of ischemic stroke a prospective study |
| topic | Brain embolism Prognosis Risk factors Stroke Transcranial Doppler ultrasonography |
| url | https://doi.org/10.1186/s13089-020-0156-1 |
| work_keys_str_mv | AT rodrigobazan relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT gustavojoseluvizutto relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT gabrielpereirabraga relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT silmeiagarciazanatibazan relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT joaocarloshueb relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT carlosclaytonmacedodefreitas relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT pedrotadaohamamotofilho relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT gabrielpinheiromodolo relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT andrepeteantrindade relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT marconelimasobreira relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT heliorubensdecarvalhonunes relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT joaopereiraleite relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy AT octaviomarquespontesneto relationshipofspontaneousmicroembolicsignalstoriskstratificationrecurrenceseverityandmortalityofischemicstrokeaprospectivestudy |