Key result
Thromboembolic stroke was associated with significantly higher rates of thoracic aortic atherosclerosis (37% vs 21%, P<0.02) and left atrial thrombus (20% vs 6%, P<0.005) compared to matched controls.
Why the study?
What transesophageal echocardiographic findings are associated with thromboembolic stroke and specific sites of arterial occlusion?
Case-Control (n=202)
What transesophageal echocardiographic findings are associated with thromboembolic stroke and specific sites of arterial occlusion?
Transesophageal echocardiography identifies specific cardiac and aortic sources of embolism that correlate with the occurrence and anatomical site of thromboembolic stroke.
These TEE associations may guide stroke etiology assessment; leaves open causal impact and need for prospective outcome trials.
The authors investigated the association of transesophageal echocardiographic findings with the site of arterial occlusion in patients who underwent transesophageal echocardiography because of thromboembolic stroke and in whom the site of arterial occlusion was diagnosed by computerized axial tomography. The study population included 101 patients (mean age 59 +/- 15 years) with thromboembolic stroke and 101 randomly selected age-matched and sex-matched control without stroke. Transesophageal echocardiographic findings that were significantly higher in the patients with thromboembolic stroke than in the control group were vegetations on the aortic or mitral valve (9% versus 1%, P < 0.01), left atrial or left atrial thrombus or spontaneous echocardiographic contrast (20% versus 6%, P < 0.005), thrombus on a prosthetic valve or in the left ventricle (4% versus 0%, P < 0.05), and atherosclerosis in the thoracic aorta (37% versus 21%, P < 0.02). A higher prevalence of atherosclerosis in the thoracic aorta was found in patients with lacunar infarction compared with patients with middle cerebral artery occlusion (67% versus 25%, P < 0.02), as well as a higher prevalence of vegetations on the aortic or mitral valve in patients with occlusion of 2 arteries compared with patients with vertebrobasilar artery occlusion (28% versus 0%, P < 0.05).
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Saleem et al. (2003) conducted a case-control in Thromboembolic stroke (n=202). Thromboembolic stroke vs. Age- and sex-matched controls without stroke was evaluated on Atherosclerosis in the thoracic aorta (p=<0.02). Thromboembolic stroke was associated with significantly higher rates of thoracic aortic atherosclerosis (37% vs 21%, P<0.02) and left atrial thrombus (20% vs 6%, P<0.005) compared to matched controls.
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