Abstract W MP61: Prevalence of Echocardiographic Abnormalities in Acute Ischemic Stroke
Introduction: Non-invasive cardiac imaging is an important tool in evaluation of acute ischemic stroke, as a cardiac source can be implicated in approximately 20% of cases. However, the preferred imaging method is unclear due in part to the lack of consistent data regarding the yield of the two most commonly employed modalities, transthoracic and transesophageal echocardiography (TTE and TEE). Here we examine, in a large, biracial population, the prevalence of abnormalities detected by echocardiography during evaluation of acute ischemic stroke.
Methods: Acute ischemic stroke cases were identified from a population of 1.3 million in the Greater Cincinnati area in 2005. Medical history and echocardiography results were determined by retrospective chart review. Echocardiographic abnormalities were pre-defined based on possibility of change in clinical decision making. All cases were abstracted by study nurses and subsequently verified by study physicians. Results were stratified by cardiac history and choice of echocardiographic technique; groups were compared using chi-square test or Fisher’s Exact test.
Results: There were 2197 hospital-ascertained ischemic stroke cases in 2005. Median age was 73 (IQR 61-81), 22% were black, and 55% were female. TTE was performed in 68% of cases; TEE was performed in 7%. TEE revealed at least one abnormality in 55% of cases with cardiac history and 32% of cases without (Table). Yield of TTE was 20% in cases with cardiac history and 3% in cases without.
Discussion: TEE is of considerable yield in selected patients, irrespective of cardiac history. This is in keeping with prior cost-effectiveness analyses recommending TEE alone for patients in whom suspicion of occult source of cardiac embolism is high. Prevalence of abnormalities on TTE in this population is similar to that of previously published series.
Author Disclosures: B. Eckerle: None. H. Sucharew: Research Grant; Significant; NS30678. K. Alwell: Research Grant; Significant; NS30678. C.J. Moomaw: Research Grant; Significant; NS30678. M. Flaherty: Research Grant; Modest; NIH Research Grant. S. Martini: Research Grant; Modest; NS 30678. D. Woo: Research Grant; Modest; NS 30678. P. Khatri: Other Research Support; Significant; PRISMS Study. O. Adeoye: Research Grant; Modest; NS 30678. S. Ferioli: Research Grant; Modest; NS 30678. B.M. Kissela: Research Grant; Significant; NS30678. D.O. Kleindorfer: Research Grant; Significant; NS30678. Speakers' Bureau; Modest; tPA Speakers Bureau.
- © 2014 by American Heart Association, Inc.