Vol 53, No 2 (2019)
Research paper
Published online: 2019-04-25
Submitted: 2019-01-04
Accepted: 2019-04-09
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Transthoracic echocardiography in the assessment of cardiogenic causes of ischaemic stroke

Wojciech Król, Anna Żarek, Aleksandra Wilk, Wioletta Guzik, Marlena Ziemska, Marcin Konopka, Magdalena Franczuk-Gwiazda, Marek Kuch, Wojciech Braksator
DOI: 10.5603/PJNNS.a2019.0016
·
Pubmed: 31020990
·
Neurol Neurochir Pol 2019;53(2):156-161.

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Vol 53, No 2 (2019)
Research paper
Published online: 2019-04-25
Submitted: 2019-01-04
Accepted: 2019-04-09

Abstract

Introduction. One of the leading causes of death in Poland is stroke. Cardiogenic stroke is known to be one of the most important reasons for acute ischaemic stroke (AIS), comprising 25–30% of all AISs.

Aim of study. Assessment of the prevalence of different risk factors of cardiogenic causes of AIS using transthoracic echocardiography (TTE).

Material and methods. Transthoracic echocardiograms performed in patients with AIS admitted to a single neurological ward between October 2013 and September 2017 were analysed. Patients were assigned, based on the results of their TTE and their previous medical history of atrial fibrillation (AF), to one of three groups depending on the level of the risk of occurrence of cardiogenic causes of AIS.

Ethical permission. According to Dz.U.2001, no. 126, 1381 no ethical permission was needed.

Results. 663 patients with AIS were included in the study. Patients with high risk of cardiogenic cause of AIS: 26.7% (N = 177 patients [p]). Of these, 64.4% (114 p) were diagnosed with AF. 31.6% (56 p) with sinus rhythm during hospitalisation had a history of paroxysmal AF (PAF). In 11.9% (21 p) of the patients qualified to the high risk group, factors other than AF were found. Patients with moderate risk of cardiogenic cause of AIS: 10.1% (67 p). Patients with low risk of cardiogenic cause of AIS: 25.9% (172 p). Echocardiographic results led to a change in therapy in 1.21% of cases.

Conclusions. 1. Transthoracic echocardiography performed routinely in all AIS patients affects the treatment in a very low percentage of cases. 2. The group that could benefit the most from TTE examination includes people without established indications for chronic anticoagulant therapy, in particular patients after myocardial infarction and people with additional clinical symptoms. 3. In patients with AIS, the diagnostic sensitivity of TTE in the detection of PFO is low. Young people with a cryptogenic ischaemic stroke should undergo a transoesophageal assessment.

Abstract

Introduction. One of the leading causes of death in Poland is stroke. Cardiogenic stroke is known to be one of the most important reasons for acute ischaemic stroke (AIS), comprising 25–30% of all AISs.

Aim of study. Assessment of the prevalence of different risk factors of cardiogenic causes of AIS using transthoracic echocardiography (TTE).

Material and methods. Transthoracic echocardiograms performed in patients with AIS admitted to a single neurological ward between October 2013 and September 2017 were analysed. Patients were assigned, based on the results of their TTE and their previous medical history of atrial fibrillation (AF), to one of three groups depending on the level of the risk of occurrence of cardiogenic causes of AIS.

Ethical permission. According to Dz.U.2001, no. 126, 1381 no ethical permission was needed.

Results. 663 patients with AIS were included in the study. Patients with high risk of cardiogenic cause of AIS: 26.7% (N = 177 patients [p]). Of these, 64.4% (114 p) were diagnosed with AF. 31.6% (56 p) with sinus rhythm during hospitalisation had a history of paroxysmal AF (PAF). In 11.9% (21 p) of the patients qualified to the high risk group, factors other than AF were found. Patients with moderate risk of cardiogenic cause of AIS: 10.1% (67 p). Patients with low risk of cardiogenic cause of AIS: 25.9% (172 p). Echocardiographic results led to a change in therapy in 1.21% of cases.

Conclusions. 1. Transthoracic echocardiography performed routinely in all AIS patients affects the treatment in a very low percentage of cases. 2. The group that could benefit the most from TTE examination includes people without established indications for chronic anticoagulant therapy, in particular patients after myocardial infarction and people with additional clinical symptoms. 3. In patients with AIS, the diagnostic sensitivity of TTE in the detection of PFO is low. Young people with a cryptogenic ischaemic stroke should undergo a transoesophageal assessment.

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Keywords

stroke, atrial fibrillation, transthoracic echocardiography, cardiogenic stroke, echocardiography

About this article
Title

Transthoracic echocardiography in the assessment of cardiogenic causes of ischaemic stroke

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 53, No 2 (2019)

Pages

156-161

Published online

2019-04-25

DOI

10.5603/PJNNS.a2019.0016

Pubmed

31020990

Bibliographic record

Neurol Neurochir Pol 2019;53(2):156-161.

Keywords

stroke
atrial fibrillation
transthoracic echocardiography
cardiogenic stroke
echocardiography

Authors

Wojciech Król
Anna Żarek
Aleksandra Wilk
Wioletta Guzik
Marlena Ziemska
Marcin Konopka
Magdalena Franczuk-Gwiazda
Marek Kuch
Wojciech Braksator

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