Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls

Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic con...
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Autor*in:	Wehrum, Thomas [verfasserIn] Dragonu, Iulius Strecker, Christoph Schuchardt, Florian Hennemuth, Anja Drexl, Johann Reinhard, Thomas Böhringer, Daniel Vach, Werner Hennig, Jürgen Harloff, Andreas

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2017

Schlagwörter:	Atherosclerosis Aorta Stroke Multi-contrast MRI 4D flow MRI

Anmerkung:	© The Author(s). 2017

Übergeordnetes Werk:	Enthalten in: Journal of cardiovascular magnetic resonance - London : BioMed Central, 1999, 19(2017), 1 vom: 06. Sept.
Übergeordnetes Werk:	volume:19 ; year:2017 ; number:1 ; day:06 ; month:09

Links:	Volltext

DOI / URN:	10.1186/s12968-017-0379-x

Katalog-ID:	SPR029038596

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520			\|a Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. Clinical trial registration Unique identifier: DRKS00006234; date of registration: 11/06/2014
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allfields	10.1186/s12968-017-0379-x doi (DE-627)SPR029038596 (SPR)s12968-017-0379-x-e DE-627 ger DE-627 rakwb eng Wehrum, Thomas verfasserin (orcid)0000-0002-2643-4363 aut Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. Clinical trial registration Unique identifier: DRKS00006234; date of registration: 11/06/2014 Atherosclerosis (dpeaa)DE-He213 Aorta (dpeaa)DE-He213 Stroke (dpeaa)DE-He213 Multi-contrast MRI (dpeaa)DE-He213 4D flow MRI (dpeaa)DE-He213 Dragonu, Iulius aut Strecker, Christoph aut Schuchardt, Florian aut Hennemuth, Anja aut Drexl, Johann aut Reinhard, Thomas aut Böhringer, Daniel aut Vach, Werner aut Hennig, Jürgen aut Harloff, Andreas aut Enthalten in Journal of cardiovascular magnetic resonance London : BioMed Central, 1999 19(2017), 1 vom: 06. Sept. (DE-627)638411602 (DE-600)2578881-4 1532-429X nnns volume:19 year:2017 number:1 day:06 month:09 https://dx.doi.org/10.1186/s12968-017-0379-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2017 1 06 09
spelling	10.1186/s12968-017-0379-x doi (DE-627)SPR029038596 (SPR)s12968-017-0379-x-e DE-627 ger DE-627 rakwb eng Wehrum, Thomas verfasserin (orcid)0000-0002-2643-4363 aut Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. Clinical trial registration Unique identifier: DRKS00006234; date of registration: 11/06/2014 Atherosclerosis (dpeaa)DE-He213 Aorta (dpeaa)DE-He213 Stroke (dpeaa)DE-He213 Multi-contrast MRI (dpeaa)DE-He213 4D flow MRI (dpeaa)DE-He213 Dragonu, Iulius aut Strecker, Christoph aut Schuchardt, Florian aut Hennemuth, Anja aut Drexl, Johann aut Reinhard, Thomas aut Böhringer, Daniel aut Vach, Werner aut Hennig, Jürgen aut Harloff, Andreas aut Enthalten in Journal of cardiovascular magnetic resonance London : BioMed Central, 1999 19(2017), 1 vom: 06. Sept. (DE-627)638411602 (DE-600)2578881-4 1532-429X nnns volume:19 year:2017 number:1 day:06 month:09 https://dx.doi.org/10.1186/s12968-017-0379-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2017 1 06 09
allfields_unstemmed	10.1186/s12968-017-0379-x doi (DE-627)SPR029038596 (SPR)s12968-017-0379-x-e DE-627 ger DE-627 rakwb eng Wehrum, Thomas verfasserin (orcid)0000-0002-2643-4363 aut Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. Clinical trial registration Unique identifier: DRKS00006234; date of registration: 11/06/2014 Atherosclerosis (dpeaa)DE-He213 Aorta (dpeaa)DE-He213 Stroke (dpeaa)DE-He213 Multi-contrast MRI (dpeaa)DE-He213 4D flow MRI (dpeaa)DE-He213 Dragonu, Iulius aut Strecker, Christoph aut Schuchardt, Florian aut Hennemuth, Anja aut Drexl, Johann aut Reinhard, Thomas aut Böhringer, Daniel aut Vach, Werner aut Hennig, Jürgen aut Harloff, Andreas aut Enthalten in Journal of cardiovascular magnetic resonance London : BioMed Central, 1999 19(2017), 1 vom: 06. Sept. (DE-627)638411602 (DE-600)2578881-4 1532-429X nnns volume:19 year:2017 number:1 day:06 month:09 https://dx.doi.org/10.1186/s12968-017-0379-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2017 1 06 09
allfieldsGer	10.1186/s12968-017-0379-x doi (DE-627)SPR029038596 (SPR)s12968-017-0379-x-e DE-627 ger DE-627 rakwb eng Wehrum, Thomas verfasserin (orcid)0000-0002-2643-4363 aut Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. Clinical trial registration Unique identifier: DRKS00006234; date of registration: 11/06/2014 Atherosclerosis (dpeaa)DE-He213 Aorta (dpeaa)DE-He213 Stroke (dpeaa)DE-He213 Multi-contrast MRI (dpeaa)DE-He213 4D flow MRI (dpeaa)DE-He213 Dragonu, Iulius aut Strecker, Christoph aut Schuchardt, Florian aut Hennemuth, Anja aut Drexl, Johann aut Reinhard, Thomas aut Böhringer, Daniel aut Vach, Werner aut Hennig, Jürgen aut Harloff, Andreas aut Enthalten in Journal of cardiovascular magnetic resonance London : BioMed Central, 1999 19(2017), 1 vom: 06. Sept. (DE-627)638411602 (DE-600)2578881-4 1532-429X nnns volume:19 year:2017 number:1 day:06 month:09 https://dx.doi.org/10.1186/s12968-017-0379-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2017 1 06 09
allfieldsSound	10.1186/s12968-017-0379-x doi (DE-627)SPR029038596 (SPR)s12968-017-0379-x-e DE-627 ger DE-627 rakwb eng Wehrum, Thomas verfasserin (orcid)0000-0002-2643-4363 aut Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. Clinical trial registration Unique identifier: DRKS00006234; date of registration: 11/06/2014 Atherosclerosis (dpeaa)DE-He213 Aorta (dpeaa)DE-He213 Stroke (dpeaa)DE-He213 Multi-contrast MRI (dpeaa)DE-He213 4D flow MRI (dpeaa)DE-He213 Dragonu, Iulius aut Strecker, Christoph aut Schuchardt, Florian aut Hennemuth, Anja aut Drexl, Johann aut Reinhard, Thomas aut Böhringer, Daniel aut Vach, Werner aut Hennig, Jürgen aut Harloff, Andreas aut Enthalten in Journal of cardiovascular magnetic resonance London : BioMed Central, 1999 19(2017), 1 vom: 06. Sept. (DE-627)638411602 (DE-600)2578881-4 1532-429X nnns volume:19 year:2017 number:1 day:06 month:09 https://dx.doi.org/10.1186/s12968-017-0379-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2017 1 06 09
language	English
source	Enthalten in Journal of cardiovascular magnetic resonance 19(2017), 1 vom: 06. Sept. volume:19 year:2017 number:1 day:06 month:09
sourceStr	Enthalten in Journal of cardiovascular magnetic resonance 19(2017), 1 vom: 06. Sept. volume:19 year:2017 number:1 day:06 month:09
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Atherosclerosis Aorta Stroke Multi-contrast MRI 4D flow MRI
isfreeaccess_bool	true
container_title	Journal of cardiovascular magnetic resonance
authorswithroles_txt_mv	Wehrum, Thomas @@aut@@ Dragonu, Iulius @@aut@@ Strecker, Christoph @@aut@@ Schuchardt, Florian @@aut@@ Hennemuth, Anja @@aut@@ Drexl, Johann @@aut@@ Reinhard, Thomas @@aut@@ Böhringer, Daniel @@aut@@ Vach, Werner @@aut@@ Hennig, Jürgen @@aut@@ Harloff, Andreas @@aut@@
publishDateDaySort_date	2017-09-06T00:00:00Z
hierarchy_top_id	638411602
id	SPR029038596
language_de	englisch
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Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. 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author	Wehrum, Thomas
spellingShingle	Wehrum, Thomas misc Atherosclerosis misc Aorta misc Stroke misc Multi-contrast MRI misc 4D flow MRI Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls
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topic_title	Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls Atherosclerosis (dpeaa)DE-He213 Aorta (dpeaa)DE-He213 Stroke (dpeaa)DE-He213 Multi-contrast MRI (dpeaa)DE-He213 4D flow MRI (dpeaa)DE-He213
topic	misc Atherosclerosis misc Aorta misc Stroke misc Multi-contrast MRI misc 4D flow MRI
topic_unstemmed	misc Atherosclerosis misc Aorta misc Stroke misc Multi-contrast MRI misc 4D flow MRI
topic_browse	misc Atherosclerosis misc Aorta misc Stroke misc Multi-contrast MRI misc 4D flow MRI
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title	Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls
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title_full	Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls
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author_browse	Wehrum, Thomas Dragonu, Iulius Strecker, Christoph Schuchardt, Florian Hennemuth, Anja Drexl, Johann Reinhard, Thomas Böhringer, Daniel Vach, Werner Hennig, Jürgen Harloff, Andreas
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title_sort	aortic atheroma as a source of stroke – assessment of embolization risk using 3d cmr in stroke patients and controls
title_auth	Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls
abstract	Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. Clinical trial registration Unique identifier: DRKS00006234; date of registration: 11/06/2014 © The Author(s). 2017
abstractGer	Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. Clinical trial registration Unique identifier: DRKS00006234; date of registration: 11/06/2014 © The Author(s). 2017
abstract_unstemmed	Background It was our purpose to identify vulnerable plaques in the thoracic aorta using 3D multi-contrast CMR and estimate the risk of cerebral embolization using 4D flow CMR in cryptogenic stroke patients and controls. Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. Clinical trial registration Unique identifier: DRKS00006234; date of registration: 11/06/2014 © The Author(s). 2017
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title_short	Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls
url	https://dx.doi.org/10.1186/s12968-017-0379-x
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author2	Dragonu, Iulius Strecker, Christoph Schuchardt, Florian Hennemuth, Anja Drexl, Johann Reinhard, Thomas Böhringer, Daniel Vach, Werner Hennig, Jürgen Harloff, Andreas
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up_date	2024-07-03T23:10:15.231Z
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Methods One hundred patients (40 with cryptogenic stroke, 60 ophthalmologic controls matched for age, sex and presence of hypertension) underwent a novel 3D multi-contrast (T1w, T2w, PDw) CMR protocol at 3 Tesla for plaque detection and characterization within the thoracic aorta, which was combined with 4D flow CMR for mapping potential embolization pathways. Plaque morphology was assessed in consensus reading by two investigators and classified according to the modified American-Heart-Association (AHA) classification of atherosclerotic plaques. Results In the thoracic aorta, plaques <4 mm thickness were found in a similar number of stroke patients and controls [23 (57.5%) versus 33 (55.0%); p = 0.81]. However, plaques ≥4 mm were more frequent in stroke patients [22 (55.0%) versus 10 (16.7%); p < 0.001]. Of those patients with plaques ≥4 mm, seven (17.5%) stroke patients and two (3.3%) controls (p < 0.001) had potentially vulnerable AHA type VI plaques. Six stroke patients with vulnerable AHA type VI plaques ≥4 mm had potential embolization pathways connecting the plaque, located in the aortic arch (n = 3) and proximal descending aorta (n = 3), with the individual territory of stroke, which made them the most likely source of stroke in those patients. Conclusions Our findings underline the significance of ≥4 mm thick and vulnerable plaques in the aortic arch and descending aorta as a relevant etiology of stroke. 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Aortic atheroma as a source of stroke – assessment of embolization risk using 3D CMR in stroke patients and controls

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