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Atrial myopathy is considered to be the underlying cause of a large proportion of embolic strokes of undetermined source. However, the definition of this atrial condition is not well delineated while its identification could lead to prescription on anticoagulation in order to avoid stroke recurences. This study aims to identify new markers of atrial myopathy and choosed a multi parametric approach with electrical, echographical, biological and 4D flow CMR derived markers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with embolic strokes of undetermined source. | Experimental | Patients over 18 years old, with embolic strokes of undetermined source, fulfilling the TOAST criteria. The intervention consists of a 4D Flow MRI. |
|
| Patients with non-paroxysmal AF. | Experimental | Patients over 18 years old, with non-paroxysmal AF. The intervention consists of a 4D Flow MRI. |
|
| Heathy volunteers | Active Comparator | The control group will include volunteers over 45 years old with no history of cardio-vascular or neuro-vascular disease. The last will be certified by a pre inclusion protocol containing a medical consultation, a Holter ECG and a trans-thoracic echocardiography. The age of 45 was chosen to get comparable age group and set the analyses free of the age-related effect on the cardiac hemodynamic. The intervention consists of an ECG, holter ECG, Trans thoracic echocardiography ETT, Blood sample and 4D Flow MRI. |
|
| ESUS and non-paroxysmal AF patients with cardiac MRI | Experimental | ESUS and non-paroxysmal AF patients (fulfilling the group 1 et 2 criteria) and who had had cardiac MRI, in a retrospective way. It corresponds to retrospective inclusion of patients which had MRI in the year before the beginning of the study. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 4D Flow MRI | Other | Acquisitions of MR imagining with special contrast phase CMR sequences. There is no need for agent contrast injection. The CMR is performed at the time of inclusion. |
| Measure | Description | Time Frame |
|---|---|---|
| Mean flow velocities in the left atrium | Velocity magnitude (cm/s) for all atrial voxels and all cardiac frames will be plotted in a histogram and normalized by the total number of voxels to allow comparisons between subjects | One Day |
| Measure | Description | Time Frame |
|---|---|---|
| Maximal flow velocities in the left atrium | Velocity magnitude (cm/s) for all atrial voxels and all cardiac frames will be plotted in a histogram and normalized by the total number of voxels to allow comparisons between subjects. Local peak velocity will be obtained by averaging 5 percent of all maximum values. | One Day |
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Inclusion Criteria:
Groupe1:Ischemic embolic stroke of undetermined source (ESUS) according to TOAST criteria (N =10)
Group 2: Non-paroxysmal AF (N=10)
Group 3: Healthy volunteers (N=10)
Pre-inclusion criteria :
Criteria for inclusion :
Group 4: Stroke-ESUS or non-paroxysmal AF with cardiac MRI (N=10)
Exclusion Criteria:
Groupe1: Ischemic embolic stroke of undetermined source (ESUS) according to TOAST criteria (N =10)
Group 2: Non-paroxysmal AF (N=10)
Group 4: Stroke-ESUS or non paroxysmal AF with cardiac MRI (N=10)
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Philippe CHEVALIER, Pr | Contact | 4.72.35.70.27 | +33 | philippe.chevalier@chu-lyon.fr |
| Sihem BEN AOUICHA, PhD | Contact | 4 72 35 69 42 | +33 | Sihem.ben-aouicha@chu-lyon.fr |
| Name | Affiliation | Role |
|---|---|---|
| Philippe CHEVALIER, Pr | Chief of the Arrhythmia Unit at the Academic Hospital of Lyon | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service d'urgences neuro-vasculaires, service de neurologie vasculaire Hôpital neurologique Pierre Wertheimer | Not yet recruiting | Bron | 69677 | France |
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|
| Medical consultation with 12 leads ECG | Other | Collection of medical history, treatment, physical examination and realization of a 12 leads ECG. |
|
| Holter ECG | Other | 48 hours ECG recording |
|
| Trans thoracic echocardiography | Other | Trans thoracic echocardiography with standard measures performes in the core lab. |
|
| Blood sample | Biological | Blood sample in a peripheral vein, send to medical laboratory to dosage of NT pro BNP and troponin serum level. |
|
| Standard MRI | Other | Acquisitions of MR imagining |
|
| Left atrium stasis |
Velocity magnitude (cm/s) for all atrial voxels and all cardiac frames will be plotted in a histogram and normalized by the total number of voxels to allow comparisons between subjects. Local peak velocity will be obtained by averaging 5 percent of all maximum values |
| One Day |
| Vortex size | Vortices in the isolated LA chamber were detectedusing the Lambda2 (λ2) method, which is an objective and widelyaccepted method to identify 3D vortice. | One Day |
| Left atrium volume | Extracted from 3D MR reconstruction, expressed in mL/m2 of body surface area. | One Day |
| Service Imagerie médicale Hôpital neurologique Pierre Wertheimer | Not yet recruiting | Bron | 69677 | France |
|
| Service rythmologie, Hôpital cardiologique Louis Pradel | Recruiting | Bron | 69677 | France |
|
| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |
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