Use of carotid intima-media thickness to identify patients with ischemic stroke and transient ischemic attack with low yield of cardiovascular sources of embolus on transesophageal echocardiography

Stroke; a Journal of Cerebral Circulation
R Parker WardRoberto M Lang

Abstract

Carotid intima-media thickness (CIMT) is associated with systemic atherosclerosis and cardioembolic conditions and predicts the risk of recurrent strokes. We sought to establish the relationship between CIMT and cardiovascular sources of embolus (CSE) on transesophageal echocardiography (TEE) and hypothesized that a noninvasive strategy of CIMT assessment and transthoracic echocardiography bubble study would identify patients with ischemic stroke or transient ischemic attack in whom TEE would provide little incremental diagnostic yield. In 180 patients with ischemic stroke or transient ischemic attack of undetermined origin referred for TEE, we prospectively performed CIMT measurement/plaque screen (Phase 1, n=96) or CIMT measurement/plaque screen and transthoracic echocardiography bubble study (Phase 2, n=84) before TEE. Phase 1 results were used to construct receiver operating characteristic curves to demonstrate the ability of CIMT to detect CSE on TEE and to identify the optimal CIMT cutoff value for prospective strategy testing (Phase 2). In Phase 1, CIMT was found to correlate with TEE markers of aortic atherosclerosis, including complex aortic plaques, and combined CSE. The optimal CIMT cutoff for detection of CSE on TEE...Continue Reading

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Citations

Dec 18, 2010·Stroke; a Journal of Cerebral Circulation·Tetsuya OhiraAaron R Folsom
Feb 26, 2011·AJNR. American Journal of Neuroradiology·L SabaG Mallarini
Sep 3, 2014·The International Journal of Neuroscience·Anastasios ChatzikonstantinouThomas Henzler
Jul 6, 2019·The Journal of International Medical Research·Qiao WangJia Zhou
Sep 19, 2019·AIDS Research and Human Retroviruses·Sarawut SiwamogsathamUNKNOWN HIV-NAT 227/HIV-NAT006 study team

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