Diagnostic Impact of Transesophageal Echocardiography in Patients with Acute Cerebral Ischemia

Autor:	Margaretha Ragaller, Ulf Bodechtel, Volker Puetz, Lars-Peder Pallesen, Jessica Kepplinger, Baerbel Wiedemann, Kristian Barlinn, Charlotte Zerna, Matthias Weise, Silke Braun, Timo Siepmann
Rok vydání:	2016
Předmět:	Male medicine.medical_specialty Heart Diseases Ischemia Infarction Comorbidity 030204 cardiovascular system & hematology Brain Ischemia Brain ischemia 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Germany medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Stroke Aged Vascular disease Intracranial Embolism business.industry Incidence Middle Aged medicine.disease Causality Embolism Acute Disease Patent foramen ovale Cardiology Female Cardiology and Cardiovascular Medicine business human activities 030217 neurology & neurosurgery Echocardiography Transesophageal
Zdroj:	Echocardiography (Mount Kisco, N.Y.). 33(4)
ISSN:	1540-8175
Popis:	Objectives Transesophageal echocardiography (TEE) is the diagnostic gold standard for the detection of structural heart diseases as potential sources of cardiac emboli in patients with acute cerebral ischemia. We sought to determine the diagnostic yield of TEE in patients with acute ischemic stroke or transient ischemic attack (TIA). Methods We retrospectively analyzed consecutive patients with acute cerebral ischemia who were admitted to our hospital between October 2008 and December 2011. TEE reports were screened for detection of cardiac source of embolism judged by the recommendation to change medical management. We performed univariate and multivariate analyses to identify predictors of clinically relevant TEE findings among baseline characteristics. Results Of 3314 patients with ischemic stroke or TIA, TEE was performed in 791 (24%) patients (mean age 64 ± 13 years, 589 [74%] ischemic stroke, 202 [26%] TIA). A potential cardioembolic source was found in 71 (9%) patients with patent foramen ovale with atrial septal aneurysm being the most common finding (24/71 patients, 34%). In multivariate analysis, peripheral vascular disease (OR 2.57; 95%CI 1.00–6.61), imaging evidence of infarction in multiple locations (OR 4.13; 95%CI 1.36–12.58), and infarction in the posterior circulation (OR 2.11; 95%CI 1.01–4.42) were associated with the identification of a potential cardioembolic source with TEE. Conclusion TEE identified a potential structural cardioembolic source in nearly 10% of our selected patient population with acute ischemic stroke or TIA, thus underlining its diagnostic value. Our data suggest that patients with hitherto unknown stroke etiology should be considered for additional TEE.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fb2442e2dd8577121d6af37051467b94 https://pubmed.ncbi.nlm.nih.gov/27103483 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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