Gadolinium-enhanced cardiac MRI: Cardiac magnetic resonance imaging (MRI) with a protocol designed to measure myocardial inflammation and fibrosis.
B Natriuretic Peptide: Measurement of B Natriuretic Peptide on patients' blood samples at 10 and 60+/-15 days.
Systemic inflammatory markers: Measurement of a panel of 92 systemic inflammatory markers on patients' blood samples at 10 and 60+/-15 days.
Study summary
The present study is an investigator initiated, single-centre, prospective, proof-of-concept cohort study aiming to enroll 44 patients with acute middle cerebral artery (MCA) ischemic stroke, involving the right (n=22) and left (n=22) MCA territories and 24 control patients with acute focal neurological symptoms but no evidence of acute brain infarct on DWI-MRI.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
• Acute ischemic stroke in the right or left MCA territory. Acute ischemic stroke is defined as acute onset focal symptoms matching an acute brain infarct documented on Head computed tomography or diffusion-weighted imaging (DWI) MRI of the brain showing restricted diffusion.
Exclusion Criteria:
* History of known atrial fibrillation, prior myocardial infarction, coronary artery disease, heart failure, prior cardiovascular surgery or percutaneous intervention.
* Previous stroke (occurred within 3 months before the index event)
* Impaired renal function defined as a creatinine clearance \<97 mL/min in men or \<88 mL/min in women, according to the Cockcroft formula.
* hs-TnT \>100 on routine acute stroke baseline bloodwork upon admission.
* Clinically or neurologically unstable patients as per the treating physician.
* Ongoing infection or recent infection within the previous 3 months
* Surgery within 3 months before the stroke
* Concurrent and active inflammatory conditions (connective tissue diseases, rheumatological disease, etc.) or use of anti-inflammatory medications
* Pregnancy, Stage IV renal insufficiency, eGFR \<30, and any other contraindications to the use of gadolinium.
* Stroke with symptomatic hemorrhagic transformation
* Subjects will be excluded if they fail the LHSC standard MRI screening questionnaire (cardiac pacemakers/wires, aneurysm clips, shunt/surgical clips, shrapnel/bullets, dentures or metal braces, intra-uterine devices, heart valves, ear implants, prostheses, medication patches such as Nicoderm, Habitrol, or Transderm-Nitro, claustrophobia, history of a head or eye injury involving metal fragments.
Primary outcome measure(s)
The severity of left ventricular myocardial inflammation on cardiac MRI within 10 days post-stroke — Within 10 days of stroke onset Proportion of left ventricular myocardium showing inflammatory changes on gadolinium-enhanced cardiac MRI
The extent of left ventricular fibrosis measured on gadolinium-enhanced cardiac MRI within 10 days of stroke onset — Within 10 days of stroke onset Proportion of left ventricular myocardium showing fibrosis on gadolinium-enhanced cardiac MRI
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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