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Patients with stroke have a 25x higher risk of cardiovascular complications within the first 30 days of the event compared to individuals without stroke. The mechanisms behind these complications are not well understood. Evidence suggests that inflammation plays a central role. With the present proof-of-concept prospective cohort study, the investigators aim to demonstrate that patients develop cardiac inflammation after stroke by performing positron emission tomography (PET) magnetic resonance imaging (MRI) of the heart within 15 days after stroke. As a secondary aim, the investigators will evaluate whether post-stroke cardiac inflammation persists at 3 months after stroke. The control group will be comprised of age- and sex-matched individuals without stroke.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cases (Ischemic stroke) | Left and right middle cerebral artery ischemic stroke Patients presenting with acute onset focal neurological deficits and DWI-MRI evidence of an acute brain infarct of the left or right middle cerebral artery ischemic stroke. |
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| Controls (TIA) | Patients with acute focal neurological symptoms without brain infarct on MRI. Patients presenting with acute onset focal neurological deficits presumed to be of vascular origin, WITHOUT DWI-MRI evidence of an acute brain infarct. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cardiac PET/MRI | Diagnostic Test | Patients will undergo cardiac PET/MRI scanning at 30±5 days and at 90±5 days post-stroke. |
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| Measure | Description | Time Frame |
|---|---|---|
| Cardiac Inflammation Levels at 30±5 Days Post-Stroke measured by PET/MR Scanning | Cardiac inflammation as measure on PET/MR scanning. | At 30 days±5 post stroke |
| Cardiac Inflammation Levels at 90±5 Days Post-Stroke measured by PET/MR Scanning | Cardiac inflammation as measure on PET/MR scanning. | At 90±5 days compared to first 30 days±5 post-stroke |
| Measure | Description | Time Frame |
|---|---|---|
| Change in B-Type Natriuretic Peptide (NT-proBNP) and HS-TnT levels between 30±5 days and 90±5 days post-stroke. | Change in levels of NT-proBNP and HS-TnT between 30±5 and 90±15 days post-stroke. | At 90±5 days compared to first 30±5 days post stroke |
| Change in systemic inflammatory markers between 30±5 and 90±5 days post-stroke |
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Inclusion Criteria:
Exclusion Criteria:
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The study population will comprise 4 patients with acute ischemic stroke in the right MCA territory involving the insular cortex, 4 patients in the left MCA territory involving the insular cortex, and 4 age- and sex-matched individuals presenting with acute stroke symptoms but no evidence of stroke on brain MRI.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Diana Ayan, MSc | Contact | +1 519.685.8500 | 35826 | diana.ayan@lhsc.on.ca |
| Jennifer Moussa | Contact | +1 519.685.8500 | 33110 | jennifer.moussa@lhsc.on.ca |
| Name | Affiliation | Role |
|---|---|---|
| Luciano Sposato, MD | London Health Sciences Center, Western University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Heart & Brain Lab, Western University | Recruiting | London | Ontario | N6A 5A5 | Canada |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| D007249 | Inflammation |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Inflammatory markers | Diagnostic Test | Measurement of a panel of 92 systemic inflammatory markers on patients' blood samples at 30±5 days and at 90±5 days post-stroke |
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| Diagnostic Test: NT-proBNP | Diagnostic Test | NT-proBNP is useful both in the diagnosis and prognosis of heart failure and is considered to be a gold standard biomarker in heart failure. Measurement of NT-proBNP on patients' blood samples at 30±5 days and at 90±5 days post-stroke |
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Systemic inflammatory markers will be measured using a high-performance biomarker panel for the following 92 proteins (all of which will be informed in pg/mL): ADA; ARTN; AXIN1; NGF; CCL13; CCL19; CCL2; CCL20; CCL23; CCL25; CCL28; CCL3; CCL4; CCL7; CCL8; CXCL10; CXCL11; CXCL5; CXCL6; CXCL9; CDCP1; CASP8; CST5; DNER; CCL11; EIF4EBP1; FGF19; FGF21; FGF23; FGF5; FLT3LG; CX3CL1; GDNF; CXCL1; HGF; IFNG; IL1A; IL10; IL10RA; IL10RB; IL12B; IL13; IL15RA; IL17A; IL17C; IL18; IL18R1; IL2; IL2RB; IL20; IL20RA; IL22RA1; IL24; IL33; IL4; IL5; IL6; IL7; CXCL8; MMP1; KITLG; LIF; LIFR; LTA; CSF1; SIRT2; CD244;NTF3;NRTN;OSM;CD274;S100A12;TGFA;STAMBP;SLAMF1;MMP10;SULT1A1;CD6;CD5;CD8A;TSLP;TGFB1;TNF;TNFSF10;TNFSF11;TNFSF12;TNFSF14;TNFRSF11B;CD40;TNFRSF9;PLAU;VEGFA |
| At 90±5 days compared to first 30±5 days |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |