Association between pouch morphology, cardiovascular risk factors and ischemic brain lesions in patients with left-sided septal pouches
Copyright © 2023 Elsevier Inc. All rights reserved..
BACKGROUND: Left atrial outpouching structures such as left atrial diverticula (LADs) and left-sided septal pouches (LSSPs) might be a source of cryptogenic stroke. This imaging study evaluates the association between pouch morphology, patient comorbidities and ischemic brain lesions (IBLs).
METHODS: This is a retrospective single-center analysis of 195 patients who received both a cardiac CT and a cerebral MRI. LADs, LSSPs, and IBLs were retrospectively identified. Size measurements included pouch width, length and volume for LADs and circumference, area and volume for LSSPs. The association between LADs/LSSPs, IBLs and cardiovascular comorbidities was determined by univariate and bivariate regression analyses.
RESULTS: The prevalence and mean volume were 36.4% and 372 ± 569 mm3 for LSSPs, and 40.5% and 415 ± 541 mm3 for LADs. The IBL prevalence was 67.6% in the LSSP group and 48.1% in the LAD group. LSSPs had 2.9-fold increased hazards of IBLs (95%CI: 1.2-7.4, p = 0.024), and LADs showed no significant correlation with IBLs. Size measurements had no impact on IBLs. A co-existing LSSP was associated with an increased prevalence of IBLs in patients with coronary artery disease (HR: 1.5, 95%CI: 1.1-1.9, p = 0.048), heart failure (HR: 3.7, 95%CI: 1.1-14.6, p = 0.032), arterial hypertension (HR: 1.9, 95%CI: 1.1-3.3, p = 0.017), and hyperlipidemia (HR: 2.2, 95%CI: 1.1-4.4, p = 0.018).
CONCLUSION: Co-existing LSSPs were associated with IBLs in patients with cardiovascular risk factors, however, pouch morphology did not correlate with the IBL rate. Upon confirmation by further studies, these findings might be considered in the treatment, risk stratification, and stroke prophylaxis of these patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:100 |
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| Enthalten in: |
Clinical imaging - 100(2023) vom: 15. Aug., Seite 36-41 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Goertz, Lukas [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiovascular imaging |
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| Anmerkungen: |
Date Completed 05.06.2023 Date Revised 05.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.clinimag.2023.04.014 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356990702 |
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| 100 | 1 | |a Goertz, Lukas |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association between pouch morphology, cardiovascular risk factors and ischemic brain lesions in patients with left-sided septal pouches |
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| 500 | |a Date Revised 05.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Left atrial outpouching structures such as left atrial diverticula (LADs) and left-sided septal pouches (LSSPs) might be a source of cryptogenic stroke. This imaging study evaluates the association between pouch morphology, patient comorbidities and ischemic brain lesions (IBLs) | ||
| 520 | |a METHODS: This is a retrospective single-center analysis of 195 patients who received both a cardiac CT and a cerebral MRI. LADs, LSSPs, and IBLs were retrospectively identified. Size measurements included pouch width, length and volume for LADs and circumference, area and volume for LSSPs. The association between LADs/LSSPs, IBLs and cardiovascular comorbidities was determined by univariate and bivariate regression analyses | ||
| 520 | |a RESULTS: The prevalence and mean volume were 36.4% and 372 ± 569 mm3 for LSSPs, and 40.5% and 415 ± 541 mm3 for LADs. The IBL prevalence was 67.6% in the LSSP group and 48.1% in the LAD group. LSSPs had 2.9-fold increased hazards of IBLs (95%CI: 1.2-7.4, p = 0.024), and LADs showed no significant correlation with IBLs. Size measurements had no impact on IBLs. A co-existing LSSP was associated with an increased prevalence of IBLs in patients with coronary artery disease (HR: 1.5, 95%CI: 1.1-1.9, p = 0.048), heart failure (HR: 3.7, 95%CI: 1.1-14.6, p = 0.032), arterial hypertension (HR: 1.9, 95%CI: 1.1-3.3, p = 0.017), and hyperlipidemia (HR: 2.2, 95%CI: 1.1-4.4, p = 0.018) | ||
| 520 | |a CONCLUSION: Co-existing LSSPs were associated with IBLs in patients with cardiovascular risk factors, however, pouch morphology did not correlate with the IBL rate. Upon confirmation by further studies, these findings might be considered in the treatment, risk stratification, and stroke prophylaxis of these patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cardiovascular imaging | |
| 650 | 4 | |a Catheter ablation | |
| 650 | 4 | |a Outpouching | |
| 650 | 4 | |a Stroke | |
| 650 | 4 | |a Thromboembolic | |
| 700 | 1 | |a Nelles, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Pennig, Lenhard |e verfasserin |4 aut | |
| 700 | 1 | |a Bunck, Alexander Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Reimer, Robert Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Fervers, Philipp |e verfasserin |4 aut | |
| 700 | 1 | |a Kabbasch, Christoph |e verfasserin |4 aut | |
| 700 | 1 | |a Maintz, David |e verfasserin |4 aut | |
| 700 | 1 | |a Celik, Erkan |e verfasserin |4 aut | |
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