open access

Vol 48, No 2 (2014)
Original research articles
Submitted: 2012-08-16
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Cerebral microembolism in patients with segmental left ventricular wall motion abnormalities

Aldona Warsz-Wianecka, Anetta Lasek-Bal, Zofia Kazibutowska
DOI: 10.1016/j.pjnns.2013.12.009
·
Neurol Neurochir Pol 2014;48(2):98-104.

open access

Vol 48, No 2 (2014)
Original research articles
Submitted: 2012-08-16

Abstract

Background and purpose

The significance of segmental heart wall motion abnormalities for stroke is unknown. The aims of the study included (1) comparison of the frequency and type of embolic signals in the middle cerebral artery in patients with segmental left ventricular wall hypokinesis due to coronary heart disease with and without stroke, and (2) determination of the relationship between inflammatory parameters, fibrinogen level, dyslipidemia and microembolic signals in the middle cerebral artery in patients with segmental heart hypokinesis.

Material and methods

The study included 68 patients with segmental heart hypokinesis (33 without stroke [group I] and 35 with stroke [group II]), as well as 37 healthy volunteers and a reference group of 30 patients. Echocardiography and carotid/transcranial Doppler with detection of microembolic signals were performed. Patients from group I and II had erythrocyte sedimentation rate, leucocyte count, triglycerides, total cholesterol, HDL, and LDL examined.

Results

Embolic signals were detected in patients with segmental heart hypokinesis significantly more frequently than in the control and reference groups. The high number of embolic signals, signals of high intensity, hypokinesis of the distal part of the intraventricular septum, increased cholesterol levels, LDL and triglycerides were all found more frequently in patients from group II than in group I. Embolic signals were detected more frequently in patients with high fibrinogen levels and leukocytosis.

Conclusions

Embolic signals in the middle cerebral artery in patients with segmental left ventricular hypokinesis have to be considered as a risk factor of stroke. The following changes are observed in patients with cardiogenic stroke: hypokinetic intraventricular septum, high intensity embolic signals, increased serum fibrinogen levels and leucocyte count. It may indicate the importance of these factors in the aetiology of stroke.

Abstract

Background and purpose

The significance of segmental heart wall motion abnormalities for stroke is unknown. The aims of the study included (1) comparison of the frequency and type of embolic signals in the middle cerebral artery in patients with segmental left ventricular wall hypokinesis due to coronary heart disease with and without stroke, and (2) determination of the relationship between inflammatory parameters, fibrinogen level, dyslipidemia and microembolic signals in the middle cerebral artery in patients with segmental heart hypokinesis.

Material and methods

The study included 68 patients with segmental heart hypokinesis (33 without stroke [group I] and 35 with stroke [group II]), as well as 37 healthy volunteers and a reference group of 30 patients. Echocardiography and carotid/transcranial Doppler with detection of microembolic signals were performed. Patients from group I and II had erythrocyte sedimentation rate, leucocyte count, triglycerides, total cholesterol, HDL, and LDL examined.

Results

Embolic signals were detected in patients with segmental heart hypokinesis significantly more frequently than in the control and reference groups. The high number of embolic signals, signals of high intensity, hypokinesis of the distal part of the intraventricular septum, increased cholesterol levels, LDL and triglycerides were all found more frequently in patients from group II than in group I. Embolic signals were detected more frequently in patients with high fibrinogen levels and leukocytosis.

Conclusions

Embolic signals in the middle cerebral artery in patients with segmental left ventricular hypokinesis have to be considered as a risk factor of stroke. The following changes are observed in patients with cardiogenic stroke: hypokinetic intraventricular septum, high intensity embolic signals, increased serum fibrinogen levels and leucocyte count. It may indicate the importance of these factors in the aetiology of stroke.

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Keywords

Cerebral microembolism, Cardiogenic cerebral stroke, Doppler ultrasound

About this article
Title

Cerebral microembolism in patients with segmental left ventricular wall motion abnormalities

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 48, No 2 (2014)

Pages

98-104

DOI

10.1016/j.pjnns.2013.12.009

Bibliographic record

Neurol Neurochir Pol 2014;48(2):98-104.

Keywords

Cerebral microembolism
Cardiogenic cerebral stroke
Doppler ultrasound

Authors

Aldona Warsz-Wianecka
Anetta Lasek-Bal
Zofia Kazibutowska

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