Abnormal left ventricular (LV) geometry is associated with extracardiac organ damage in patients with hypertension. The aim of this study was to determine the relationship between LV geometry and white matter lesions (WMLs) in ischemic stroke patients. We retrospectively analyzed data from 155 patients (median age 62; 49.8% male) with mild ischemic stroke (median National Institutes of Health Stroke Scale score 4) who underwent brain magnetic resonance imaging and echocardiography. Patients were categorized into four groups: normal LV geometry, concentric remodeling, eccentric left ventricular hypertrophy (LVH) and concentric LVH. WMLs were graded using the Fazekas scale on fluid-attenuated inversion recovery images. Extensive WMLs were defined as a Fazekas score > 2. Extensive WMLs were more prevalent in patients with concentric LVH, eccentric LVH and concentric remodeling than in those with normal LV geometry. After adjusting for hypertension, age, diabetes mellitus, hypercholesterolemia, glomerular filtration rate and ischemic heart disease, patients with concentric remodeling [odds ratio (OR) 3.94, 95% confidence interval (CI) 1.26-12.31, p = 0.02] and those with concentric LVH (OR 3.69, 95% CI 1.24-10.95, p = 0.02), but not patients with eccentric LVH (OR 2.44, 95% CI 0.72-8.29, p = 0.15), had higher risk of extensive WMLs than patients with normal LV geometry.
We present own results of the treatment of acute ischemic stroke by mechanical thrombectomy. Procedures were conducted in the Center for Acute Ischemic Stroke Treatment (CITO) at the University Hospital in Krakow that was established for this study. The Center works in the 24/7 system, and according to the protocol 6 professionals who participate in the procedure starts it within 45 minutes after the call of the Center coordinator. Since January the 1st 2013 till September the 30th 2016, 96 procedures were performed. Three months followup was performed in the consecutive 74 patients (39 men), mean age: 65,8±13,1 and here we present their data. Mean NIHSS score on admission was 15,4±4,2 points. In 46 patients (62.2%) mechanical thrombectomy was preceded by rt-PA-IV administration. Mean time from stroke onset to groin puncture was 265±88,5 minutes. After the procedure TICI=3 was obtained by 26 patients (35.1%), 2b – by 12 patients (16.2%), 2a – 19 patients (25.7%), 1 – 8 patients (10.8%) and 0 – by 9 patients (12.2%). Head CT scan done 24 hours after thrombectomy did not show hemorrhagic transformation in 37 patients. According to ECASS1 classification HI1 was found in 11 patients (14.9%), H12 – in 16 patients (21.6%), PH1 – in 4 patients (5.4%) and PH2 – in 6 patients (8.1%). Fourteen patients (18.9%) died within 90 days after stroke onset, and 38 – scored 80-100 points in Barthel Index (51.4%). Presented results indicate similar safety and efficacy profile of mechanical thrombectomy in the treatment of ischemic stroke performed in the system that was organized for this specific reason.
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