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Transoesophageal echocardiography in patients with acute stroke with sinus rhythm and no cardiac disease history

Authors
 Hyun-Ji Cho  ;  Hye-Yeon Choi  ;  Young Dae Kim  ;  Hyo-Suk Nam  ;  Sang Won Han  ;  Jong Won Ha  ;  Nam-Sik Chung  ;  Ji Hoe Heo 
Citation
 JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, Vol.81(4) : 412-415, 2010 
Journal Title
 JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY 
ISSN
 0022-3050 
Issue Date
2010
MeSH
Acute Disease ; Algorithms ; Echocardiography, Transesophageal/methods* ; Electrocardiography ; Female ; Heart/physiology* ; Humans ; Intracranial Embolism/complications ; Intracranial Embolism/diagnosis* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Sinoatrial Node/physiology* ; Stroke/diagnosis* ; Stroke/etiology ; Stroke/physiopathology* ; Tomography, X-Ray Computed
Abstract
BACKGROUND: Transoesophageal echocardiography (TOE) is the gold standard for detecting potential cardiac sources of embolism (PCSE). However, the role of TOE in patients with ischaemic stroke with normal sinus rhythm (NSR) and no cardiac disease remains uncertain. METHODS: The authors retrospectively analysed 1833 consecutive patients with ischaemic stroke with NSR and no history of cardiac disease who were examined by TOE. The authors investigated the frequency of PCSE and aortic plaques detected in these patients. Determination of high- and medium-risk PCSE was based on the Trial of ORG 10172 in the Acute Stroke Treatment classification. The authors also determined how the proportions of stroke subtypes and treatment strategies based on current guidelines have been changed after TOE. RESULTS: PCSE and/or aortic plaques were detected in 753 (41.1%) of 1833 patients. After TOE, a total of 355 PCSE (45 high-risk PCSE and 310 medium-risk PCSE) were found in 323 patients (17.6%). Aortic plaques were found in 502 patients (27.4%). Among these, complex aortic plaques, which are significant sources of embolism, were found in 157 patients (8.5%). Changes in treatment strategies for secondary prevention based on the current guidelines would have been necessary in 63 patients (3.4 %) after TOE examination. CONCLUSION: Potential embolic sources from the heart and aorta can be detected by TOE examination in many patients with stroke with NSR and no cardiac disease, which enables a better determination of stroke mechanisms.
Full Text
http://jnnp.bmj.com/content/81/4/412.long
DOI
10.1136/jnnp.2009.190322
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Chung, Nam Sik(정남식)
Choi, Hye Yoen(최혜연)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101380
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