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Clinical and echocardiographic characteristics of cardioembolic stroke.

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Title: Clinical and echocardiographic characteristics of cardioembolic stroke.
Authors: Ferkh, A. (AUTHOR), Brown, P. (AUTHOR), O'Keefe, E. (AUTHOR), Zada, M. (AUTHOR), Duggins, A. (AUTHOR), Thiagalingam, A. (AUTHOR), Altman, M. (AUTHOR), Boyd, A. (AUTHOR), Byth, K. (AUTHOR), Kizana, E. (AUTHOR), Denniss, A. R. (AUTHOR), Thomas, L. (AUTHOR)
Source: European Journal of Neurology. Oct2019, Vol. 26 Issue 10, p1310-1317. 8p. 1 Black and White Photograph, 3 Charts, 2 Graphs.
Subjects: Stroke, Odds ratio, Etiology of diseases, Stroke patients
Abstract: Background and purpose: Ischaemic stroke frequently has a cardioembolic (CE) source. Clinical and echocardiographic parameters associated with CE stroke were evaluated. Methods: In all, 93 consecutive ischaemic stroke patients who underwent a transthoracic echocardiogram were retrospectively analysed; strokes were classified by TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. Echocardiographic parameters related to CE stroke, including left atrial volumes and function, were compared to 73 healthy controls. Results: Of 93 patients (mean age 66.1 years, 56% male), nine (10%) had large artery atherosclerosis, 38 (41%) CE stroke, two (2%) small vessel disease, two (2%) other and 42 (45%) undetermined aetiology. Left atrial (LA) maximum volumes (LAVImax) and minimum volumes (LAVImin) were larger in the CE group than the non‐CE group (45 vs. 32 ml/m2, 32 vs. 13 ml/m2, respectively, P < 0.001), whilst LA function indices including LA emptying fraction and LA function index (LAFI) were lower in the CE group (34% vs. 55%, and 0.12 vs. 0.35, respectively, P < 0.001). Adjusting for clinical characteristics, LAFI ≤0.3 was an independent predictor of CE stroke (adjusted odds ratio 5.3, P = 0.001). Additionally, LAVImax and LAVImin were larger (61 vs. 44 and 32 vs. 24 ml/m2 respectively, P < 0.01) and LAFI significantly lower (0.34 vs. 0.52, P < 0.001) in the undetermined aetiology group versus healthy controls. Conclusions: Left atrial enlargement with reduced LA function was associated with CE stroke and LAFI was the best independent predictor. LA parameters were also altered in the undetermined aetiology group, suggesting an underlying LA myopathy in this subset. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Clinical and echocardiographic characteristics of cardioembolic stroke.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ferkh%2C+A%2E%22&quot;&gt;Ferkh, A.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Brown%2C+P%2E%22&quot;&gt;Brown, P.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22O&#39;Keefe%2C+E%2E%22&quot;&gt;O&#39;Keefe, E.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zada%2C+M%2E%22&quot;&gt;Zada, M.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Duggins%2C+A%2E%22&quot;&gt;Duggins, A.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Thiagalingam%2C+A%2E%22&quot;&gt;Thiagalingam, A.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Altman%2C+M%2E%22&quot;&gt;Altman, M.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Boyd%2C+A%2E%22&quot;&gt;Boyd, A.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Byth%2C+K%2E%22&quot;&gt;Byth, K.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kizana%2C+E%2E%22&quot;&gt;Kizana, E.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Denniss%2C+A%2E+R%2E%22&quot;&gt;Denniss, A. R.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Thomas%2C+L%2E%22&quot;&gt;Thomas, L.&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Journal+of+Neurology%22&quot;&gt;European Journal of Neurology&lt;/searchLink&gt;. Oct2019, Vol. 26 Issue 10, p1310-1317. 8p. 1 Black and White Photograph, 3 Charts, 2 Graphs.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Stroke%22&quot;&gt;Stroke&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Odds+ratio%22&quot;&gt;Odds ratio&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Etiology+of+diseases%22&quot;&gt;Etiology of diseases&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Stroke+patients%22&quot;&gt;Stroke patients&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and purpose: Ischaemic stroke frequently has a cardioembolic (CE) source. Clinical and echocardiographic parameters associated with CE stroke were evaluated. Methods: In all, 93 consecutive ischaemic stroke patients who underwent a transthoracic echocardiogram were retrospectively analysed; strokes were classified by TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. Echocardiographic parameters related to CE stroke, including left atrial volumes and function, were compared to 73 healthy controls. Results: Of 93 patients (mean age 66.1&#160;years, 56% male), nine (10%) had large artery atherosclerosis, 38 (41%) CE stroke, two (2%) small vessel disease, two (2%) other and 42 (45%) undetermined aetiology. Left atrial (LA) maximum volumes (LAVImax) and minimum volumes (LAVImin) were larger in the CE group than the non‐CE group (45 vs. 32&#160;ml/m2, 32 vs. 13&#160;ml/m2, respectively, P&#160;&lt;&#160;0.001), whilst LA function indices including LA emptying fraction and LA function index (LAFI) were lower in the CE group (34% vs. 55%, and 0.12 vs. 0.35, respectively, P&#160;&lt;&#160;0.001). Adjusting for clinical characteristics, LAFI ≤0.3 was an independent predictor of CE stroke (adjusted odds ratio 5.3, P&#160;=&#160;0.001). Additionally, LAVImax and LAVImin were larger (61 vs. 44 and 32 vs. 24&#160;ml/m2 respectively, P&#160;&lt;&#160;0.01) and LAFI significantly lower (0.34 vs. 0.52, P&#160;&lt;&#160;0.001) in the undetermined aetiology group versus healthy controls. Conclusions: Left atrial enlargement with reduced LA function was associated with CE stroke and LAFI was the best independent predictor. LA parameters were also altered in the undetermined aetiology group, suggesting an underlying LA myopathy in this subset. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1111/ene.13981
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        Type: general
      – SubjectFull: Odds ratio
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      – SubjectFull: Etiology of diseases
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              Text: Oct2019
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