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Prevalence of Echocardiographic Abnormalities in Acute Ischemic Stroke

Eckerle, Bryan
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459528281

Abstract Details

2016, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Introduction: Non-invasive cardiac imaging is an important tool in evaluation of acute ischemic stroke, as a cardiac source can be implicated in approximately 25% 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 2010. 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. Echocardiographic reports were also independently verified by study physician. 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 2265 hospital-ascertained ischemic stroke cases in 2010. Median age was 71 (IQR 59-82), 21% were black, and 55% were female. TTE was performed in 70% of cases; TEE was performed in 9%. TEE revealed at least one abnormality in 38% of cases with cardiac history and 42% of cases with-out (p=0.62). Yield of TTE was 19% in cases with cardiac history and 5% in cases without (p<0.01). 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.
Erin Nicole Haynes, Dr.P.H. (Committee Chair)
Dawn Kleindorfer, M.D. (Committee Member)
Heidi Sucharew, Ph.D. (Committee Member)
18 p.
Surgery

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Citations

  • Eckerle, B. (2016). Prevalence of Echocardiographic Abnormalities in Acute Ischemic Stroke [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459528281

    APA Style (7th edition)

  • Eckerle, Bryan. Prevalence of Echocardiographic Abnormalities in Acute Ischemic Stroke. 2016. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459528281.

    MLA Style (8th edition)

  • Eckerle, Bryan. "Prevalence of Echocardiographic Abnormalities in Acute Ischemic Stroke." Master's thesis, University of Cincinnati, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459528281

    Chicago Manual of Style (17th edition)

ucin1459528281
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© 2016, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.