What is the clinical evidence from this study?

Study design: Observational. Population: Ischemic stroke (n=77). Intervention: Atrial fibrillation vs. Sinus rhythm. Primary outcome: Left atrial spontaneous echo contrast (p=<0.01).

What does this research mean for the field?

Transesophageal echocardiography detects left atrial spontaneous echo contrast in 73% of elderly ischemic stroke patients with atrial fibrillation compared to 14% of those in sinus rhythm, highlighting differing embolic sources based on cardiac rhythm. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 1999Open Access

Transesophageal Echocardiographic Detection of Cardiac Sources of Embolism in Elderly Patients with Ischemic Stroke.

Q: What are the key findings of this study?

Transesophageal echocardiography detected left atrial spontaneous echo contrast in 73% of elderly ischemic stroke patients with atrial fibrillation compared to 14% of those in sinus rhythm (p<0.01).

Q: What does this research mean for the field?

Transesophageal echocardiography detects left atrial spontaneous echo contrast in 73% of elderly ischemic stroke patients with atrial fibrillation compared to 14% of those in sinus rhythm, highlighting differing embolic sources based on cardiac rhythm. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Transesophageal echocardiography detected left atrial spontaneous echo contrast in 73% of elderly ischemic stroke patients with atrial fibrillation compared to 14% of those in sinus rhythm (p<0.01).

Study Design

Type

Observational (n=77)

Structured PICO

Does transesophageal echocardiography detect different cardiac sources of embolism in elderly ischemic stroke patients with atrial fibrillation compared to those in sinus rhythm?

Population

77 elderly patients (≥ 70 years old, mean age 76.9) with ischemic stroke, including 37 in sinus rhythm and 40 in atrial fibrillation.

Intervention

Transesophageal echocardiography (TEE)

Comparator

Comparison between patients in sinus rhythm and patients in atrial fibrillation

Outcome

Detection of cardiac sources of embolism (left atrial spontaneous echo contrast, left atrial thrombus, patent foramen ovale, atrial septal aneurysm, and aortic atherosclerotic plaque)surrogate

Transesophageal echocardiography reveals that elderly stroke patients with atrial fibrillation more commonly have left atrial spontaneous echo contrast and thrombus, whereas those in sinus rhythm more commonly have patent foramen ovale, atrial septal aneurysm, and aortic atherosclerotic plaques.

Main Result

Absolute Event Rate: 73% vs 14%

p-value: p=<0.01

Abstract

OBJECTIVE: The aim of this study was to clarify the role of transesophageal echocardiography in detecting cardiac sources of embolism in elderly stroke patients. METHODS: We performed transesophageal echocardiography in 77 patients > or = 70 years old (mean 76.9) with ischemic stroke and investigated embolic sources. Thirty-seven patients were in sinus rhythm (SR) and 40 in atrial fibrillation (Af). RESULTS: Left atrial spontaneous echo contrast was detected in 73% of Af and in 14% of SR (p or = 4.0 mm in thickness in the proximal aortic arch were more commonly found in patients with SR. CONCLUSIONS: In elderly ischemic stroke patients, 1) Left atrial spontaneous echo contrast and thrombus are more commonly detected in patients with Af, reflecting left atrial enlargement and blood stasis, and 2) atrial septal aneurysm, patent foramen ovale and aortic atherosclerotic plaque > or = 4.0 mm in thickness in the proximal aortic arch are important findings in patients with SR.

Perguntar à IA

Bookmark

View Full Paper