{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:39:05Z","timestamp":1792157945643,"version":"4.4.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The potential causes or sources of embolic stroke of undetermined source (ESUS) vary. This study aimed to investigate the main cause of deep ESUS by evaluating nonstenotic intracranial atherosclerotic plaque.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We retrospectively screened consecutive patients with unilateral anterior circulation ESUS. After excluding the patients with possible embolism from an extracranial artery such as aortic arch plaque, carotid plaque, and so on, the enrolled patients with ESUS were categorized into 2 groups: deep ESUS and cortical with\/without\u00a0deep ESUS. All patients underwent intracranial high\u2010resolution magnetic resonance imaging to assess the characteristics of nonstenotic intracranial atherosclerotic plaque. Biomarkers of atrial cardiopathy (ie, P\u2010wave terminal force in lead V1 on ECG, NT\u2010proBNP [N\u2010terminal pro\u2013brain natriuretic peptide] and left atrial diameter) were collected. A total of 155 patients with ipsilateral nonstenotic intracranial atherosclerotic plaque were found, with 76 (49.0%) in deep ESUS and 79 (51.0%) in cortical with\/without deep ESUS. We found more prevalent plaque in the M1 segment of the middle cerebral artery and the ostia of the perforator, with a smaller remodeling index plaque burden, and less frequent occurrence of complicated plaque in deep ESUS versus cortical with\/without deep ESUS. Higher BNP (brain natriuretic peptide) levels and a higher prevalence of atrial cardiopathy in cortical with\/without deep ESUS versus deep ESUS. Moreover, the discrimination of vulnerable plaque for predicting ESUS was significantly enhanced after adjusting for or further excluding patients with deep ESUS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The current study provides the first high\u2010resolution magnetic resonance imaging evidence that cortical with\/without deep ESUS and deep ESUS should be 2 distinct entities and that atherosclerosis, not embolism, might be the main cause of deep ESUS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.026737","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T10:58:24Z","timestamp":1666868304000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Atherosclerosis as a Potential Cause of Deep Embolic Stroke of Undetermined Source: A 3T High\u2010Resolution Magnetic Resonance Imaging Study"],"prefix":"10.1161","volume":"11","author":[{"given":"Na","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Neurology General Hospital of Northern Theater Command Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi\u2010Yang","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Neurology General Hospital of Northern Theater Command Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9280-2195","authenticated-orcid":false,"given":"Lin","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Neurology General Hospital of Northern Theater Command Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben\u2010Qiang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology General Hospital of Northern Theater Command Shenyang 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