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Effect of Atrial Fibrillation on Acute Ischemic Stroke Severity

Open Journal of Medical Imaging 2014年第2期4卷 95-101页

作者： Taha Kamel Alloush Mahmoud Haroun Ibrahim Nahed Salah el Dein Ahmed Ibrahim ghada samir el-shahed Lobna Mohamed Nabil el-Sayed Mohamed Hamdy Ibrahim Hosam Ahmed Azmy Faculty of Medicine Ain Shams University Cairo Egypt Ministry of Health Cairo Egypt

Objectives: To assess the impact of atrial fibrillation on stroke severity and short-term (1 month) mortality. Materials and Methods: Totally 200 patients admitted to Ain Shams University Specialized Hospital were recruited and diagnosed clinically to have acute ischemic stroke within 3 days. Patients with hemorrhagic infarctions were excluded. History taking about previous heart disease was taken, full general and neurological examinations were done. Full metabolic profile, full cardiac investigations, carotid duplex, MRI brain stroke protocol with initial clinical evaluation and after 1 month re-evaluation using (NIHSS ) scale. Results: All patients underwent transthoracic echocardiography which revealed absence of “A” wave corresponding to atrial fibrillation in 33 patients (16.5%). Those Patients with atrial fibrillation had a median NIHSS score of 11.00 with IQR of 6.00 - 18.50 at admission and 6.00 with IQR of 2.00 - 14.50 after one month. Patients with atrial fibrillation showed significantly higher NIHSS at admission than patients in sinus rhythm, P el stenosis in 117 (79.1%) patients. 51 (34.4%) patients had lacunar infarction, 65 (43.9%) patients had partial anterior circulation infarction, 25 (16.2%) patients had posterior circulation infarction and 7 (4.7%) patients had total anterior circulation infarction. 111 (75%) patients showed leucoaraiosis. Conclusion: Atrial fibrillation was found not to have significantly statistical effect on stroke severity and short term mortality.

关键词： Atrial Fibrillation (AF)

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Effect of Heart Failure on Acute Ischemic Stroke Severity

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Open Journal of Medical Imaging 2014年第3期4卷 103-107页

作者： Taha Kamel Alloush Mahmoud Haroun Ibrahim Nahed Salah el-Dein Ahmed ghada samir el-shahed Lobna M. el-Nabil el-Sayed Mohamed Hamdy Ibrahim Hosam Ahmed Azmy Faculty of Medicine Ain Shams University Cairo Egypt Ministry of Health Cairo Egypt

Objectives: To assess the impact of heart failure diseases on stroke severity and short term (1 month mortality). Materials and Methods: Totally, 200 patients admitted to Ain Shams university specialized hospital, were diagnosed clinically to have acute ischemic stroke within 3 days. History taking about previous heart disease was taken, and full general and neurological examinations were done. Full metabolic profile, cardiac examination and investigations were done. Carotid duplex, MRI stroke protocol and lastly clinical reevaluation using NIH Stroke Scale (NIHSS) after 1 month from stroke onset were done. Results: Patients with systolic dysfunction (EF ≤ 40%) had lacunar infarction in 18.75% of cases, partial anterior circulation infarction in 62.5% of cases, posterior circulation infarction in 6.25% of cases and total anterior circulation infarction in 12.5% of cases. Leucoaraiosis was present in 87% of cases and significant intracranial vessel stenosis was showed in 87.5% who had done MRI. Their median NIHSS score at admission was 10.5 with IQR of 5 - 21 and at follow-up it was 5 with IQR of 2.5 - 10.5. At follow-up 22.7% (5 patients) were dead. Conclusion: Systolic dysfunction (EF < 40) i.e. heart failure has no significant effect on stroke severity and 1 month follow up prognosis.

关键词： Heart Failure Stroke Prognosis Ejection Fraction

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