Publications by authors named "Nick Lobe"
Background: Cardiac computed tomography (CT) is increasingly used to search for cardioembolic sources of acute ischemic stroke (AIS). We assessed the association between high-risk cardioembolic sources on cardiac CT and AIS.
Methods: We performed a case-control study using data from a prospective cohort including consecutive adult patients with suspected stroke who underwent cardiac CT acquired during the initial stroke imaging protocol between 2018 and 2020.
Background: Lithopaedion, or "stone baby," represents an exceptionally rare clinical phenomenon with fewer than 350 documented cases existing in the medical literature. This condition arises when an advanced extrauterine pregnancy ceases its developmental trajectory and undergoes a lithification process, potentially resulting in a calcified mass with fetal-like morphology. Typically, lithopaedions remain asymptomatic for decades, but may occasionally elicit acute symptoms necessitating medical intervention.
View Article and Find Full Text PDFBackground: Obesity increases the risk of atrial fibrillation (AF). We hypothesize that 'obese' epicardial adipose tissue (EAT) is, regardless of comorbidities, associated with markers of AF vulnerability.
Methods: Patients >40y of age undergoing bariatric surgery and using <2 antihypertensive drugs and no insulin were prospectively included.
Article Synopsis
- This study investigates the impact of left atrial appendage (LAA) slow-flow on ischemic stroke outcomes, finding that 16% of patients had slow-flow and shared characteristics with those having LAA thrombus.
- While both slow-flow and thrombus were linked to a higher prevalence of atrial fibrillation, patients with thrombus experienced more severe strokes and worse functional outcomes than those with slow-flow.
- Ultimately, slow-flow did not significantly affect functional outcomes or major cardiovascular events, but it was associated with an increased risk of stroke recurrence in patients with unknown causes of their strokes.
Background: Cardiac computed tomography (CT) acquired during the initial acute stroke imaging protocol (acute cardiac CT) is increasingly used to screen for cardioembolism, but information on the long-term clinical implications of its findings is lacking.
Methods And Results: We performed a prospective, single-center cohort study in which consecutive patients with ischemic stroke underwent ECG-gated acute cardiac CT and were followed up for 2 years. The primary outcome was functional outcome assessed using the modified Rankin Scale.
Article Synopsis
- Cardiac thrombi, found in about 8% of patients with acute ischemic stroke, are often located in the left atrial appendage and are linked to more severe strokes and poor outcomes.
- In a study of 452 patients, those with cardiac thrombi had higher NIHSS scores (indicating more severe symptoms) and more complications like multiple vascular occlusions compared to those without.
- Although thrombi were associated with worse functional outcomes, the rate of stroke recurrence at 90 days was not significantly different between the two groups.
Article Synopsis
- The study explores the variability in human spleen morphology, focusing on the presence of clefts and accessory spleens, and hypothesizes that these variations arise from incomplete fusion of spleen primordia during development.
- Researchers analyzed spleens from embryos, fetuses, and adults using various imaging techniques, and found no significant correlation between the developmental stage and the number of clefts present.
- The results suggest that the spleen's morphological variations are normal and not indicative of developmental abnormalities, calling for a re-evaluation of terms like "persistent foetal lobulation."
Background And Objectives: Guidelines recommend echocardiography to screen for structural sources of cardioembolism in patients with ischemic stroke. Cardiac CT is a promising alternative as a first-line screening method. We aimed to determine whether cardiac CT, acquired during the initial stroke imaging protocol, has a higher yield for detecting high-risk cardioaortic sources of embolism than transthoracic echocardiography (TTE).
View Article and Find Full Text PDFPurpose: The first objective of this study was to evaluate the efficacy of a patient-tailored contrast delivery protocol for coronary computed tomography angiography (CTCA), in terms of diagnostic coronary attenuation and total iodine load (TIL), by adjusting the iodine delivery rate (IDR) via dilution for body weight and tube voltage (kV), as compared with a protocol with a fixed bolus of contrast in a clinical setting. The secondary objective was to assess the association between the test-bolus data and luminal attenuation in CTCA.
Materials And Methods: Patients who underwent CTCA with fixed IDR contrast delivery (cohort 1) or with IDR adjusted for body weight and kV settings (70 to 120 kV) (cohort 2) were included, and compared for intravascular luminal attenuation and TIL.
Rationale: About one-third of ischaemic strokes are caused by cardioembolism, and a substantial proportion of cryptogenic strokes likely also originate from the heart or aortic arch. Early determination of aetiology is important to optimise management. Computed Tomography-angiography of the heart is emerging as an alternative to echocardiography to detect cardio-aortic sources of embolism in stroke patients, but its diagnostic yield in acute ischaemic stroke has not been thoroughly assessed.
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