Identification of New Markers of Atrial Myopathy in Patients With Embolic Stroke of Undetermined Source (ESUS) From MRI 4D Data (IRM 4D-AVC)

This is an interventional basic science trial for Embolic Stroke of Undetermined Source focused on measuring Atrial Myopathy, Atrial Fibrillation, ESUS, MRI, blood velocity, left atrium Read More

Inclusion Criteria:

Groupe1:Ischemic embolic stroke of undetermined source (ESUS) according to TOAST criteria (N =10)

• Age ≥ 18 years old
• Non-gap ischemic stroke diagnosed on MRI or CT scan of the brain (gap stroke defined as a cerebral infarction ≤ 1.5 cm / ≤2.0 cm on diffusion sequences).
• No major cardio-embolic source (episode of atrial fibrillation or flutter > 6min, intracardiac thrombus, LVEF <30 percent recent myocardial infarction (<4 weeks), mitral stenosis, valvular vegetation or infectious endocarditis).
• Absence of atherosclerosis causing stenosis ≥ 50 percent of the lumen of the intra or extra cranial arteries that vascularise the infarcted cerebral area.
• No other specific cause identified (arteritis, arterial dissection, migraine/vaso-spasm, toxic cause).
• Affiliation to a social security scheme
• Patient who signed the consent

Group 2: Non-paroxysmal AF (N=10)

• Age ≥ 18 years old
• Subject with documented non-paroxysmal AF
• Affiliation to a social security scheme
• Patient who signed the consent

Group 3: Healthy volunteers (N=10)

Pre-inclusion criteria :

• Age ≥ 45 years old
• Patient with no documented cardiac or neuro-vascular history
• Affiliation to a social security scheme
• Patient who signed the consent
• Registration on the VRB file (Volontaires Recherches Biomédicales, https://vrb.sante.gouv.fr) or response to the published announcement

Criteria for inclusion :

• ECG in sinus rhythm
• Holter ECG: no AF
• Normal Trans thoracic echocardiography
• Patient with no neuro-vascular history

Group 4: Stroke-ESUS or non-paroxysmal AF with cardiac MRI (N=10)

• Age ≥ 18 years old
• Subject with a documented stroke-ESUS or documented non-paroxysmal FA
• Subject with cardiac MRI
• Affiliation to a social security scheme
• Subject having given its non-opposition

Exclusion Criteria:

Groupe1: Ischemic embolic stroke of undetermined source (ESUS) according to TOAST criteria (N =10)

• Risk of pregnancy or pregnancy (proven on interrogation data or pregnancy test).
• Contraindication to MRI ferromagnetic material (in particular pacemaker, implantable defibrillator, cardiac valve prosthesis, cochlear implant, neuro-stimulator, implanted automated injection material, intraocular metallic foreign body, neurosurgical and vascular clips, claustrophobia)
• Less than 8 weeks after implantation of a stent
• Subject participating in another intervention research including a period of exclusion still in progress at the pre-inclusion stage.

Group 2: Non-paroxysmal AF (N=10)

• Risk of pregnancy or pregnancy (proven on interview data or pregnancy test).
• Contraindication to MRI ferromagnetic material (in particular pacemaker, implantable defibrillators, cardiac valve prosthesis, cochlear implant, neurostimulators, implanted automated injection equipment, intraocular metallic foreign body, neurosurgical and vascular clips, claustrophobia).
• Less than 8 weeks after implantation of a stent
• Subject participating in another intervention research including a period of exclusion still in progress at the pre-inclusion stage.

Group 4: Stroke-ESUS or non paroxysmal AF with cardiac MRI (N=10)

• History of neuro-vascular or cardiac pathology
• Risk of pregnancy or pregnancy (proven on interrogation data or pregnancy test).
• Contraindication to MRI (ferromagnetic material (in particular pacemaker, implantable defibrillator, cardiac valve prosthesis, cochlear implant, neuro-stimulator, implanted automated injection material, intraocular metallic foreign body, neurosurgical and vascular clips, claustrophobia)
• Subject participating in another intervention research including a period of exclusion still in progress at the pre-inclusion stage.