Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology

Autores
Rodriguez Granillo, Gaston Alfredo; Cirio, Juan J.; Ciardi, Celina; Caballero, Maria L.; Fontana, Lucia A.; Buezas, Mariano D.; Diluca, Pablo; Lylyk, Pedro
Año de publicación
2022
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Hyperacute cardiac imaging of patients with acute ischemic stroke (AIS), though desirable, is impractical. Using delayed-enhancement, low-dose, non-gated, chest spectral computed tomography scans (DESCT), we explored the prevalence and patterns of incidental myocardial late iodine enhancement (LIE) and embolic sources, and their relationship with stroke etiology. Methods: Since July 2020, DESCT was performed after cerebrovascular CT angiography (CTA) among patients with suspected AIS undergoing CT using a dual-layer spectral scanner, without additional contrast administration. Images were analyzed using monoenergetic reconstructions and iodine density maps, and the myocardial extracellular volume fraction (ECV, %) was calculated. Results: Eighty patients with AIS were included. DESCT identified a cardiac thrombi in 6 patients (7.5%), and a complex aortic plaque in 4 (5%) cases; reclassifying 5 embolic strokes of uncertain source (28% of ESUS) to cardioembolic (CE, n = 3) and non-CE (n = 2) etiologies. LIE was identified in 38 (48%) patients, most commonly (82%) of ischemic pattern. We did not identify significant relationships between AIS etiology and the presence, pattern, and extent of LIE (p > 0.05); ECV (p = 0.56), severe aortic (p = 0.25) or valvular (p = 0.26) disease, or the extent of coronary calcification (p = 0.39). Patients with evidence of major cardiovascular DESCT findings had higher rates of all-cause death at 90 days (42% vs. 19%, p = 0.037). Conclusions: In this study, hyperacute cardiac imaging of AIS with DESCT identified a high prevalence of incidental cardiac disease predominantly involving LIE of ischemic etiology and mostly not related to the stroke etiology.
Fil: Rodriguez Granillo, Gaston Alfredo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional - Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas "Prof. Dr. Alberto C. Taquini". Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional; Argentina. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Cirio, Juan J.. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Ciardi, Celina. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Caballero, Maria L.. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Fontana, Lucia A.. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Buezas, Mariano D.. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Diluca, Pablo. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Lylyk, Pedro. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Materia
CARDIAC DISEASE
CARDIOVASCULAR COMPUTED TOMOGRAPHY
DUAL ENERGY
EMBOLIC STROKE
MYOCARDIAL DELAYED-ENHANCEMENT
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/216270
Acceder
id CONICETDig_6944688b1a16ef8a74458dc1451caf48
oai_identifier_str oai:ri.conicet.gov.ar:11336/216270
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with EtiologyRodriguez Granillo, Gaston AlfredoCirio, Juan J.Ciardi, CelinaCaballero, Maria L.Fontana, Lucia A.Buezas, Mariano D.Diluca, PabloLylyk, PedroCARDIAC DISEASECARDIOVASCULAR COMPUTED TOMOGRAPHYDUAL ENERGYEMBOLIC STROKEMYOCARDIAL DELAYED-ENHANCEMENThttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: Hyperacute cardiac imaging of patients with acute ischemic stroke (AIS), though desirable, is impractical. Using delayed-enhancement, low-dose, non-gated, chest spectral computed tomography scans (DESCT), we explored the prevalence and patterns of incidental myocardial late iodine enhancement (LIE) and embolic sources, and their relationship with stroke etiology. Methods: Since July 2020, DESCT was performed after cerebrovascular CT angiography (CTA) among patients with suspected AIS undergoing CT using a dual-layer spectral scanner, without additional contrast administration. Images were analyzed using monoenergetic reconstructions and iodine density maps, and the myocardial extracellular volume fraction (ECV, %) was calculated. Results: Eighty patients with AIS were included. DESCT identified a cardiac thrombi in 6 patients (7.5%), and a complex aortic plaque in 4 (5%) cases; reclassifying 5 embolic strokes of uncertain source (28% of ESUS) to cardioembolic (CE, n = 3) and non-CE (n = 2) etiologies. LIE was identified in 38 (48%) patients, most commonly (82%) of ischemic pattern. We did not identify significant relationships between AIS etiology and the presence, pattern, and extent of LIE (p > 0.05); ECV (p = 0.56), severe aortic (p = 0.25) or valvular (p = 0.26) disease, or the extent of coronary calcification (p = 0.39). Patients with evidence of major cardiovascular DESCT findings had higher rates of all-cause death at 90 days (42% vs. 19%, p = 0.037). Conclusions: In this study, hyperacute cardiac imaging of AIS with DESCT identified a high prevalence of incidental cardiac disease predominantly involving LIE of ischemic etiology and mostly not related to the stroke etiology.Fil: Rodriguez Granillo, Gaston Alfredo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional - Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas "Prof. Dr. Alberto C. Taquini". Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional; Argentina. Clinica La Sagrada Familia. Instituto Medico ENERI; ArgentinaFil: Cirio, Juan J.. Clinica La Sagrada Familia. Instituto Medico ENERI; ArgentinaFil: Ciardi, Celina. Clinica La Sagrada Familia. Instituto Medico ENERI; ArgentinaFil: Caballero, Maria L.. Clinica La Sagrada Familia. Instituto Medico ENERI; ArgentinaFil: Fontana, Lucia A.. Clinica La Sagrada Familia. Instituto Medico ENERI; ArgentinaFil: Buezas, Mariano D.. Clinica La Sagrada Familia. Instituto Medico ENERI; ArgentinaFil: Diluca, Pablo. Clinica La Sagrada Familia. Instituto Medico ENERI; ArgentinaFil: Lylyk, Pedro. Clinica La Sagrada Familia. Instituto Medico ENERI; ArgentinaMedreviews, Llc2022-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/216270Rodriguez Granillo, Gaston Alfredo; Cirio, Juan J.; Ciardi, Celina; Caballero, Maria L.; Fontana, Lucia A.; et al.; Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology; Medreviews, Llc; Reviews In Cardiovascular Medicine; 23; 3; 3-2022; 1-81530-6550CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.imrpress.com/journal/RCM/23/3/10.31083/j.rcm2303093info:eu-repo/semantics/altIdentifier/doi/10.31083/j.rcm2303093info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-10-15T14:48:53Zoai:ri.conicet.gov.ar:11336/216270instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-10-15 14:48:53.413CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology
title Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology
spellingShingle Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology
Rodriguez Granillo, Gaston Alfredo
CARDIAC DISEASE
CARDIOVASCULAR COMPUTED TOMOGRAPHY
DUAL ENERGY
EMBOLIC STROKE
MYOCARDIAL DELAYED-ENHANCEMENT
title_short Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology
title_full Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology
title_fullStr Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology
title_full_unstemmed Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology
title_sort Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology
dc.creator.none.fl_str_mv Rodriguez Granillo, Gaston Alfredo
Cirio, Juan J.
Ciardi, Celina
Caballero, Maria L.
Fontana, Lucia A.
Buezas, Mariano D.
Diluca, Pablo
Lylyk, Pedro
author Rodriguez Granillo, Gaston Alfredo
author_facet Rodriguez Granillo, Gaston Alfredo
Cirio, Juan J.
Ciardi, Celina
Caballero, Maria L.
Fontana, Lucia A.
Buezas, Mariano D.
Diluca, Pablo
Lylyk, Pedro
author_role author
author2 Cirio, Juan J.
Ciardi, Celina
Caballero, Maria L.
Fontana, Lucia A.
Buezas, Mariano D.
Diluca, Pablo
Lylyk, Pedro
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv CARDIAC DISEASE
CARDIOVASCULAR COMPUTED TOMOGRAPHY
DUAL ENERGY
EMBOLIC STROKE
MYOCARDIAL DELAYED-ENHANCEMENT
topic CARDIAC DISEASE
CARDIOVASCULAR COMPUTED TOMOGRAPHY
DUAL ENERGY
EMBOLIC STROKE
MYOCARDIAL DELAYED-ENHANCEMENT
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: Hyperacute cardiac imaging of patients with acute ischemic stroke (AIS), though desirable, is impractical. Using delayed-enhancement, low-dose, non-gated, chest spectral computed tomography scans (DESCT), we explored the prevalence and patterns of incidental myocardial late iodine enhancement (LIE) and embolic sources, and their relationship with stroke etiology. Methods: Since July 2020, DESCT was performed after cerebrovascular CT angiography (CTA) among patients with suspected AIS undergoing CT using a dual-layer spectral scanner, without additional contrast administration. Images were analyzed using monoenergetic reconstructions and iodine density maps, and the myocardial extracellular volume fraction (ECV, %) was calculated. Results: Eighty patients with AIS were included. DESCT identified a cardiac thrombi in 6 patients (7.5%), and a complex aortic plaque in 4 (5%) cases; reclassifying 5 embolic strokes of uncertain source (28% of ESUS) to cardioembolic (CE, n = 3) and non-CE (n = 2) etiologies. LIE was identified in 38 (48%) patients, most commonly (82%) of ischemic pattern. We did not identify significant relationships between AIS etiology and the presence, pattern, and extent of LIE (p > 0.05); ECV (p = 0.56), severe aortic (p = 0.25) or valvular (p = 0.26) disease, or the extent of coronary calcification (p = 0.39). Patients with evidence of major cardiovascular DESCT findings had higher rates of all-cause death at 90 days (42% vs. 19%, p = 0.037). Conclusions: In this study, hyperacute cardiac imaging of AIS with DESCT identified a high prevalence of incidental cardiac disease predominantly involving LIE of ischemic etiology and mostly not related to the stroke etiology.
Fil: Rodriguez Granillo, Gaston Alfredo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional - Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas "Prof. Dr. Alberto C. Taquini". Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional; Argentina. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Cirio, Juan J.. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Ciardi, Celina. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Caballero, Maria L.. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Fontana, Lucia A.. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Buezas, Mariano D.. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Diluca, Pablo. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
Fil: Lylyk, Pedro. Clinica La Sagrada Familia. Instituto Medico ENERI; Argentina
description Background: Hyperacute cardiac imaging of patients with acute ischemic stroke (AIS), though desirable, is impractical. Using delayed-enhancement, low-dose, non-gated, chest spectral computed tomography scans (DESCT), we explored the prevalence and patterns of incidental myocardial late iodine enhancement (LIE) and embolic sources, and their relationship with stroke etiology. Methods: Since July 2020, DESCT was performed after cerebrovascular CT angiography (CTA) among patients with suspected AIS undergoing CT using a dual-layer spectral scanner, without additional contrast administration. Images were analyzed using monoenergetic reconstructions and iodine density maps, and the myocardial extracellular volume fraction (ECV, %) was calculated. Results: Eighty patients with AIS were included. DESCT identified a cardiac thrombi in 6 patients (7.5%), and a complex aortic plaque in 4 (5%) cases; reclassifying 5 embolic strokes of uncertain source (28% of ESUS) to cardioembolic (CE, n = 3) and non-CE (n = 2) etiologies. LIE was identified in 38 (48%) patients, most commonly (82%) of ischemic pattern. We did not identify significant relationships between AIS etiology and the presence, pattern, and extent of LIE (p > 0.05); ECV (p = 0.56), severe aortic (p = 0.25) or valvular (p = 0.26) disease, or the extent of coronary calcification (p = 0.39). Patients with evidence of major cardiovascular DESCT findings had higher rates of all-cause death at 90 days (42% vs. 19%, p = 0.037). Conclusions: In this study, hyperacute cardiac imaging of AIS with DESCT identified a high prevalence of incidental cardiac disease predominantly involving LIE of ischemic etiology and mostly not related to the stroke etiology.
publishDate 2022
dc.date.none.fl_str_mv 2022-03
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/216270
Rodriguez Granillo, Gaston Alfredo; Cirio, Juan J.; Ciardi, Celina; Caballero, Maria L.; Fontana, Lucia A.; et al.; Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology; Medreviews, Llc; Reviews In Cardiovascular Medicine; 23; 3; 3-2022; 1-8
1530-6550
CONICET Digital
CONICET
url http://hdl.handle.net/11336/216270
identifier_str_mv Rodriguez Granillo, Gaston Alfredo; Cirio, Juan J.; Ciardi, Celina; Caballero, Maria L.; Fontana, Lucia A.; et al.; Hyperacute Incidental Late Myocardial Enhancement in Ischemic Stroke Using Chest Spectral CT: Relationship with Etiology; Medreviews, Llc; Reviews In Cardiovascular Medicine; 23; 3; 3-2022; 1-8
1530-6550
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.imrpress.com/journal/RCM/23/3/10.31083/j.rcm2303093
info:eu-repo/semantics/altIdentifier/doi/10.31083/j.rcm2303093
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Medreviews, Llc
publisher.none.fl_str_mv Medreviews, Llc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1846083010530639872
score 13.22299

Publicaciones similares