Association of homocysteine and smoking with cerebral microemboli in patients with mechanical heart valves:a transcranial Doppler study  

作　　者：Alicia Mattia M Reza Azarpazhooh Claudio Munoz Chrysi Bogiatzi Mackenzie A Quantz J David Spence 

机构地区：[1]Stroke Prevention and Atherosclerosis Research Centre,Robarts Research Institute,Western University,London,Ontario,Canada [2]Department of Neurology,McMaster University,Hamilton,Ontario,Canada [3]Division of Epidemiology and Biostatistics,Western University,London,Ontario,Canada [4]Division of Neurology,Western University,London,Ontario,Canada [5]Division of Cardiac Surgery,Western University,London,Ontario,Canada [6]Division of Clinical Pharmacology,Western University,London,Ontario,Canada

出　　处：《Stroke & Vascular Neurology》2017年第4期199-204,共6页卒中与血管神经病学（英文）

基　　金：The study was funded by donations to the Stroke Prevention&Atherosclerosis Research Centre,mainly from patients attending the stroke prevention clinics.

摘　　要：Objectives Microembolic signals(MES)on transcranial Doppler(TCD)predict stroke and cognitive decline.Plasma levels of total homocysteine(tHcy),a prothrombotic factor,are higher in patients with microemboli in carotid stenosis and in patients with paradoxical embolism.In this study we assessed the association between the level of tHcy and the number of MES in patients with mechanical heart valves(MHVs).Methods TCD monitoring was performed to detect MES before and after breathing 100% oxygen and repeated every 2-4 weeks up to six times.results Twenty-five patients with MHVs(mean age:63.60±10.15 years)participated in this study;15 were men(66.47±7.25 years)and 10 were women(59.30±12.60 years).In total,there were 126 study visits.In multiple regression,higher tHcy was associated with more MES in both preoxygenation(OR 1.34(95%CI 1.07 to 1.68,P=0.009))and postoxygenation(OR 1.40(95% CI 1.07 to 1.83,P=0.01))phases.Current smoking and the length of time between the operation and monitoring also correlated with a higher number of MES before and after breathing oxygen,particularly in women.conclusions Higher tHcy and smoking were associated with a higher MES count in both preoxygenation and postoxygenation phases.Because smoking can be stopped and hyperhomocysteinaemia is treatable,these are clinically important findings.

关 键 词：PATIENTS assessed CEREBRAL 

分 类 号：R74[医药卫生—神经病学与精神病学]