2026-04-27T22:04:53Zhttps://uvadoc.uva.es/oai/request

oai:uvadoc.uva.es:10324/644402024-12-18T10:09:08Zcom_10324_1179com_10324_931com_10324_894col_10324_1306

Imaging Biomarkers and Prevalence of Complex Aortic Plaque in Cryptogenic Stroke: A Systematic Review Sakai, Yu Cao, Quy Rubin, Jeremy Witsch, Jens Cohen‐Addad, Dan de Macedo Rodrigues, Katyucia Coco Martín, María Begoña Pasyar, Pouyan Juega, Jesús Fan, Zhaoyang Kasner, Scott E. Cucchiara, Brett L. Song, Jae W. Producción Científica BACKGROUND: Complex aortic plaque (CAP) is a potential embolic source in patients with cryptogenic stroke (CS). We review CAP imaging criteria for transesophageal echocardiogram (TEE), computed tomography angiography (CTA), and magnetic resonance imaging and calculate CAP prevalence in patients with acute CS. METHODS AND RESULTS: PubMed and EMBASE databases were searched up to December 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Two independent reviewers extracted data on study design, imaging techniques, CAP criteria, and prevalence. The Cochrane Collaboration tool and Guideline for Reporting Reliability and Agreement Studies were used to assess risk of bias and reporting completeness, respectively. From 2293 studies, 45 were reviewed for CAP imaging biomarker criteria in patients with acute CS (N=37 TEE; N=9 CTA; N=6 magnetic resonance imaging). Most studies (74%) used ≥4 mm plaque thickness as the imaging criterion for CAP although ≥1 mm (N=1, CTA), ≥5 mm (N=5, TEE), and ≥6 mm (N=2, CTA) were also reported. Additional features included mobility, ulceration, thrombus, protrusions, and assessment of plaque composition. From 23 prospective studies, CAP was detected in 960 of 2778 patients with CS (0.32 [95% CI, 0.24–0.41], I2=94%). By modality, prevalence estimates were 0.29 (95% CI, 0.20–0.40; I2=95%) for TEE; 0.23 (95% CI, 0.15–0.34; I2=87%) for CTA and 0.22 (95% CI, 0.06–0.54; I2=92%) for magnetic resonance imaging. CONCLUSIONS: TEE was commonly used to assess CAP in patients with CS. The most common CAP imaging biomarker was ≥4 mm plaque thickness. CAP was observed in one-third of patients with acute CS. However, high study heterogeneity suggests a need for reproducible imaging methods. 2024-01-11T11:23:32Z 2024-01-11T11:23:32Z 2023 info:eu-repo/semantics/article J Am Heart Assoc. 2023 Dec 5;12(23) 2047-9980 https://uvadoc.uva.es/handle/10324/64440 10.1161/JAHA.123.031797 1 23 13 Journal of the American Heart Association 12 2047-9980 eng info:eu-repo/semantics/openAccess http://creativecommons.org/publicdomain/zero/1.0/ CC0 1.0 Universal AHA Journals SI