Yield of Echocardiography in the Evaluation of Cerebral Ischemic Events: A Single Center Cohort Study
Date
2019
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Article
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Abstract
Background: Echocardiography (ECO) is frequently used as a screening test in patients with acute ischemic brain disease. We aimed to evaluate the additional information and therapeutic impact resulting from ECO in these patients. Methods: We conducted a prospective study performing ECO on consecutive patients with ischemic stroke or transient ischemic attacks, admitted to our centre between February 2013 and May 2017. Results: A total of 696 patients were included (female, 57.3%; mean age, 70 ± 15.3 years). Seven hundred thirty two echocardiographic examinations were performed (696 transthoracic and 36 transesophageal). Echocardiography yielded findings judged of clinical importance in 142 patients (20.4%, 95% CI 17.5-23.5). The most frequent of these were left atrial volume enlargement or a normal evaluation. Echocardiography findings resulted in changes in the management of 76 patients (10.7% 95% CI 8.8-13.4); initiation of anticoagulation therapy, administration of IV antibiotic therapy, cardiac surgeries, or other pharmacological therapies occurring in 42 cases (6%). The presence of coronary heart disease (OR: 2.64 95% CI 1.34-5.25), atrial fibrillation (OR: 0.24; 95% CI, 0.2-0.69), and admission NIHSS (OR: 1.04; 95% CI, 1.01-1.09), were the variables associated with changes in management. Conclusions: In unselected patients with acute ischemic stroke ECO had a low yield of additional information, and it changed management in a small percentage of patients.
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Citation
Brunser AM, Ibañez-Arenas R, Larico M, Mansilla E, Almeida J, Olavarría VV, Muñoz P, Rojo A, Cavada G, Lavados PM. Yield of Echocardiography in the Evaluation of Cerebral Ischemic Events: A Single Center Cohort Study. J Stroke Cerebrovasc Dis. 2019 Mar;28(3):562-568. doi: 10.1016/j.jstrokecerebrovasdis.2018.10.042.
Keywords
Acute stroke, Ischemic stroke, Echocardiography, Diagnosis