Background
The aim of this study was the detection of risk factors for lacunar strokes with visible
lesions on computed tomography (CT) scan, considering in particular clinical characteristics,
echocardiographic parameters, and carotid–femoral pulse wave velocity (PWV, a marker
of large-artery stiffness). Lacunar strokes with very small or nonvisible lesions
may have different risk factors.
Methods
We examined 106 patients (mean age 66.9 ± 12.3 years, 60 men), including 55 patients
with clinically lacunar stroke associated with deep ischemic lesions of .3-1.5 cm
on brain CT scan, and 51 control patients with cortical ischemic stroke, with lesions
of 2.5-10.0 cm.
Results
In multiple logistic regression, with respect to cortical strokes, the following variables
were independently associated with lacunar strokes: tricuspid regurgitation velocity
(inverse relationship, odds ratio [OR] .13, 95% confidence interval [CI] .04-.43,
P = .0007, cutoff at 228 cm/s), mean systolic blood pressure (SBP) (OR 3.98, 95% CI
2.78-7.79, P = .008, cutoff at 145 mmHg), ever-smoker status (OR 2.68, 95% CI 1.06-6.80, P = .04), and atrial fibrillation (inverse relationship, OR .11, 95% CI .01-1.00, P = .0496). In univariate analysis, the patients with lacunar stroke also had a lower
prevalence of mitral regurgitation. There were no differences between the 2 groups
in relation to diabetes, cholesterol, left ventricular mass and dimensions, and PWV.
Conclusions
The patients with lacunar strokes with visible cerebral lesions on CT scan, compared
with the patients with cortical infarct, had a lower tricuspid regurgitation velocity,
a higher mean SBP, a greater prevalence of ever-smokers, and a lower prevalence of
atrial fibrillation.
Key Words
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Article info
Publication history
Published online: March 19, 2016
Accepted:
January 29,
2016
Received:
October 30,
2015
Footnotes
Grant support: This study was self-financed: no sources of funding of grants have to be acknowledged.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.01.050
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
