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Utility of Plain Chest Computed Tomography in Diagnosing Cardioembolic Stroke due to Paroxysmal Atrial Fibrillation
https://dmu.repo.nii.ac.jp/records/2173
https://dmu.repo.nii.ac.jp/records/2173d0bbe2c8-966e-4419-af5b-e5701f241f64
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
DJMS-46-1-Tsukahara-本文 (143.1 kB)
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| Item type | 学術雑誌論文 / Journal Article(1) | |||||
|---|---|---|---|---|---|---|
| タイトル | ||||||
| タイトル | Utility of Plain Chest Computed Tomography in Diagnosing Cardioembolic Stroke due to Paroxysmal Atrial Fibrillation | |||||
| 言語 | ||||||
| 言語 | eng | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | chest computed tomography | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | paroxysmal atrial fibrillation | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | left atrial volume | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | transthoracic echocardiography | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | cardioembolic stroke | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
| 資源タイプ | journal article | |||||
| 著者 |
Tsukahara, Yuka
× Tsukahara, Yuka× Takekawa, Hidehiro× Iwasaki, Akio× Suzuki, Keisuke× Hirata, Koichi |
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| 著者所属 | ||||||
| 値 | Department of Neurology, Dokkyo Medical University | |||||
| 著者所属 | ||||||
| 値 | Department of Neurology, Dokkyo Medical University, Stroke Center, Dokkyo Medical University Hospital, Center of Medical Ultrasonics, Dokkyo Medical University Hospital | |||||
| 著者所属 | ||||||
| 値 | Department of Neurology, Dokkyo Medical University | |||||
| 著者所属 | ||||||
| 値 | Department of Neurology, Dokkyo Medical University | |||||
| 著者所属 | ||||||
| 値 | Department of Neurology, Dokkyo Medical University | |||||
| 書誌情報 |
Dokkyo Journal of Medical Sciences 巻 46, 号 1, p. 9-16, 発行日 2019-03-25 |
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| 要旨 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | Background：Diagnosing cardioembolic stroke due to paroxysmal atrial fibrillation（PAF）is difficult, mainly due to low detection rate. We evaluated whether left atrial volume, which can be simply measured using non-contrast chest computed tomography（CT-LAV）, can contribute to the diagnosis of cardioembolic stroke due to PAF（PAF-CE）. Methods：Fifty-one consecutive patients with acute ischemic stroke within 24 h of onset were included in this study. Upon admission, we measured the left atrial diameter using transthoracic echocardiography（TTE-LAD）and CT-LAV. Patient background factors such as sex, age, and stroke risk factors were noted as well as brain natriuretic peptide（BNP）value and QTc interval were evaluated on admission. Utilities of BNP value, CT-ALV, and TTE-LAD in PAF-CE diagnosis were compared. Results：Patients were classified into three groups：cerebral thrombosis（CTB）group including large-artery atherosclerosis and small-vessel occlusion（n＝16）, cardioembolic stroke due to non-valvular atrial fibrillation（AF-CE）group（n＝20）, and cardioembolic stroke due to paroxysmal atrial fibrillation（PAF-CE）group（n＝15）. BNP value was highest in the AF-CE group（240.5 pg/mL）, followed by the PAF-CE（187.9 pg/mL）and CTB groups（35.0 pg/mL）（p＜0.001）. There was a significant difference in TTE-LAD among the groups（AF-CE group, 43.8 mm；PAF-CE group, 38.3 mm；CTB group, 34.1 mm）（p＜0.001）. CT-LAV was higher in the AF-CE group（142 mm3）than in the PAF-CE（95.8 mm3）and CTB groups（95.8 mm3）（p＜0.001）. In differentiating PAF-CE, the area under the receiver operating characteristic curve was 0.867, 0.742, and 0.845 for BNP value, TTE-LAD, and CT-LAV, respectively. A cut-off CT-LAV value of ≥ 69.6 mm3 had a high diagnostic rate（＞80％ of sensitivity, specificity, positive predictive value, negative predictive value, and accuracy）. Conclusion：CT-LAV can be useful in diagnosing PAF-CE. Further studies with larger sample size are required to confirm our findings and determine better cut-off value for CT-LAV. |
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| 記事種別 | ||||||
| 値 | Original | |||||
| 出版者 | ||||||
| 出版者 | 獨協医学会 | |||||
| ISSN | ||||||
| 収録物識別子タイプ | ISSN | |||||
| 収録物識別子 | 03855023 | |||||
