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  1. Dokkyo Journal of Medical Sciences
  2. 46(1) 2019

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/2173
d0bbe2c8-966e-4419-af5b-e5701f241f64
名前 / ファイル ライセンス アクション
DJMS-46-1-3.pdf DJMS-46-1-Tsukahara-本文 (143.1 kB)
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

WEKO 10200

en Tsukahara, Yuka

Search repository
Takekawa, Hidehiro

× Takekawa, Hidehiro

WEKO 1748

en Takekawa, Hidehiro

Search repository
Iwasaki, Akio

× Iwasaki, Akio

WEKO 10201

en Iwasaki, Akio

Search repository
Suzuki, Keisuke

× Suzuki, Keisuke

WEKO 10202

en Suzuki, Keisuke

Search repository
Hirata, Koichi

× Hirata, Koichi

WEKO 300

en Hirata, Koichi

Search repository
著者所属
Department of Neurology, Dokkyo Medical University
著者所属
Department of Neurology, Dokkyo Medical University, Stroke Center, Dokkyo Medical University Hospital, Center of Medical Ultrasonics, Dokkyo Medical University Hospital
著者所属
Department of Neurology, Dokkyo Medical University
著者所属
Department of Neurology, Dokkyo Medical University
著者所属
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
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.
記事種別
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
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