Abstract Details

Title Evaluation of PTFV1 as a Marker of Atrial Cardiopathy in Patients with Spontaneous ICH and DWI Lesions

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 085

Objective To evaluate if restricted diffusion lesions on magnetic resonance imaging (MRI) in patients with acute intracerebral hemorrhage (ICH) are associated with atrial cardiopathy

Background Spontaneous ICH is a devastating disease with the highest morbidity and mortality of all stroke subtypes. Presence of diffusion-weighted imaging (DWI) lesions in patients with acute ICH portends a poor prognosis. Markers of atrial disease, such as increased P-Terminal Force in lead V1 (PTFV1) on electrocardiogram (ECG), have been associated with increased stroke risk. We sought to evaluate if DWI lesions on MRI after acute ICH were associated with atrial cardiopathy, defined by PTFV1 > 40 mm/msec.

Design/Methods Retrospective chart review was performed on 325 adults admitted with ICH between 2011-2017. After selection for patients with spontaneous ICH and exclusion of patients on long-term anticoagulation or with known atrial fibrillation (AF), 161 patients were eligible for inclusion, of whom 115 (71.4%) had an MRI obtained during admission. PTFV1 on first ECG was manually measured by two raters.

Results Of 31 patients (27.0%) with DWI lesions on MRI, 14 patients (45.2%) had only perihematomal lesions, 7 patients (22.6%) had only remote lesions, and 10 patients (32.3%) had both remote and perihematomal lesions. Interrater reliability for PTFV1 was slight (κ=0.03). PTFV1 > 40 mm/msec occurred in 16 patients (51.6%) with DWI lesions and 54 patients (64.3%) without DWI lesions [P=0.188]. 12 patients (10.4%) developed new-onset AF during ICH admission, which was not associated with presence of DWI lesions [6 (50%) vs 6 (50%), P= 0.067] or PTFV1> 40 mm/msec [7 (58.3%) vs 4 (33.3%), P= 0.067]. Patients with DWI lesions were less likely to survive to hospital discharge [25 (80.6%) vs 80 (95.2%), P=0.036].

Conclusions No significant association was observed between PTFV1 and DWI lesions after spontaneous ICH.

Authors/Disclosures
Amy Thomas PRESENTER	Ms. Thomas has nothing to disclose.
Kevin N. Sheth, MD, F�鶹��ýӳ�� (Yale UniversityDivision of Neuro and Critical Care)	Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.
Rachel Beekman, MD (Yale New Haven Medical Center)	Dr. Beekman has nothing to disclose.

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