ABSTRACT

Objective

The onset of cardiogenic cerebral embolism is sudden, dangerous, and often has high morbidity and mortality. Improving understanding of factors contributing to outcomes of cardiogenic cerebral embolism will improve prognostic and therapeutic capabilities.

Methods

Through PubMed and Google Scholar, this paper examined and analyzed the factors implicated in the outcome of patients with cardiogenic cerebral embolism using the key terms ‘cardiogenic cerebral embolism’, ‘atrial fibrillation’, ‘stroke related diseases’, ‘collateral circulation’, ‘emboli profile’, ‘epigenetic’ up to 28 February 2021. Full texts of the retrieved articles were accessed. In general, in these literatures, National Institute Health of Stroke Scale (NIHSS) score ≥ 17, modified Rankin Scale (mRS) score ≥ 2, stroke recurrence, death caused by stroke are regarded as the criteria of poor prognosis. As long as one of these conditions occurs, it is judged as poor prognosis.

Results

Factors influencing patient outcomes including patient outcome include severity of neurological impairment, types and severity of combined heart diseases, establishment of cerebral collateral circulation, treatments, components of emboli causing cardiogenic cerebral embolism, existence and control of other system complications, distribution and expression of inflammatory immune cells and molecules in the course of cardiogenic cerebral embolism, and epigenetic changes related to disease prognosis.

Conclusion

Regarding to prevention and treatment of cardiogenic cerebral embolism, the related factors, such as clinical setting, emboli pathological profile, and epigenetic changes should be emphasized so that outcomes and recurrence of cardiogenic cerebral embolism can be improvised.

中文翻译：

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影响心源性脑栓塞预后的因素：文献综述

摘要

客观的

心源性脑栓塞的发病是突然的、危险的，并且通常具有很高的发病率和死亡率。提高对导致心源性脑栓塞结果的影响因素的理解将提高预后和治疗能力。

方法

通过 PubMed 和 Google Scholar，本文使用关键词“心源性脑栓塞”、“心房颤动”、“中风相关疾病”、“侧支循环”、“ emboli profile', 'epigenetic' 截至 2021 年 2 月 28 日。检索到的文章全文已被访问。一般来说，在这些文献中，美国国立脑卒中健康量表（NIHSS）评分≥17分、改良Rankin量表（mRS）评分≥2分、脑卒中复发、脑卒中导致的死亡被认为是预后不良的标准。只要出现其中一种情况，就判断为预后不良。

结果

影响患者预后的因素包括患者预后，包括神经损伤的严重程度、合并心脏病的类型和严重程度、脑侧支循环的建立、治疗、导致心源性脑栓塞的栓子成分、其他系统并发症的存在和控制、炎症的分布和表达心源性脑栓塞病程中的免疫细胞和分子，以及与疾病预后相关的表观遗传变化。

结论

对于心源性脑栓塞的防治，应重视临床环境、栓子病理特征、表观遗传变化等相关因素，以期改善心源性脑栓塞的预后和复发。