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The value of transesophageal echocardiography for embolic strokes of undetermined source

Katsanos, Aristeidis H
Autor Katsanos, Aristeidis H From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Bhole, Rohini
Autor Bhole, Rohini From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Frogoudaki, Alexandra
Autor Frogoudaki, Alexandra From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Giannopoulos, Sotirios
Autor Giannopoulos, Sotirios From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Goyal, Nitin
Autor Goyal, Nitin From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Vrettou, Agathi-Rosa
Autor Vrettou, Agathi-Rosa From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Ikonomidis, Ignatios
Autor Ikonomidis, Ignatios From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Paraskevaidis, Ioannis
Autor Paraskevaidis, Ioannis From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Pappas, Konstantinos
Autor Pappas, Konstantinos From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Parissis, John
Autor Parissis, John From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Kyritsis, Athanassios P
Autor Kyritsis, Athanassios P From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Alexandrov, Anne W
Autor Alexandrov, Anne W From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Triantafyllou, Nikos
Autor Triantafyllou, Nikos From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Malkoff, Marc D
Autor Malkoff, Marc D From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Voumvourakis, Konstantinos
Autor Voumvourakis, Konstantinos From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Alexandrov, Andrei V
Autor Alexandrov, Andrei V From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic
Tsivgoulis, Georgios
Autor Tsivgoulis, Georgios From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic. tsivgoulisgiorg@yahoo.gr

Neurology. 2016 Sep 06 ; 87 (10) : 988-95. [epub] 20160803

ISSN 1526-632X | 0028-3878
Zdroj

Jazyk angličtina Země Spojené státy americké Médium print-electronic

Typ dokumentu časopisecké články, metaanalýza, multicentrická studie, přehledy, systematický přehled

Perzistentní odkaz https://www.medvik.cz/link/pmid27488602

Online Plný text

PubMed 27488602
PubMed Central PMC5027807
DOI 10.1212/wnl.0000000000003063
PII: WNL.0000000000003063
Knihovny.cz E-zdroje

MeSH
antikoagulancia terapeutické užití MeSH
centra terciární péče MeSH
cévní mozková příhoda diagnostické zobrazování terapie MeSH
dospělí MeSH
echokardiografie transezofageální * MeSH
intrakraniální embolie diagnostické zobrazování terapie MeSH
lidé MeSH
pozorovací studie jako téma MeSH
prospektivní studie MeSH
Check Tag
dospělí MeSH
lidé MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
metaanalýza MeSH
multicentrická studie MeSH
přehledy MeSH
systematický přehled MeSH
Geografické názvy
Řecko MeSH
Tennessee MeSH
Názvy látek
antikoagulancia MeSH

OBJECTIVE: Our aim was to evaluate the diagnostic yield of transesophageal echocardiography (TEE) in consecutive patients with ischemic stroke (IS) fulfilling the diagnostic criteria of embolic strokes of undetermined source (ESUS). METHODS: We prospectively evaluated consecutive patients with acute IS satisfying ESUS criteria who underwent in-hospital TEE examination in 3 tertiary care stroke centers during a 12-month period. We also performed a systematic review and meta-analysis estimating the cumulative effect of TEE findings on therapeutic management for secondary stroke prevention among different IS subgroups. RESULTS: We identified 61 patients with ESUS who underwent investigation with TEE (mean age 44 ± 12 years, 49% men, median NIH Stroke Scale score = 5 points [interquartile range: 3-8]). TEE revealed additional findings in 52% (95% confidence interval [CI]: 40%-65%) of the study population. TEE findings changed management (initiation of anticoagulation therapy, administration of IV antibiotic therapy, and patent foramen ovale closure) in 10 (16% [95% CI: 9%-28%]) patients. The pooled rate of reported anticoagulation therapy attributed to abnormal TEE findings among 3,562 acute IS patients included in the meta-analysis (12 studies) was 8.7% (95% CI: 7.3%-10.4%). In subgroup analysis, the rates of initiation of anticoagulation therapy on the basis of TEE investigation did not differ (p = 0.315) among patients with cryptogenic stroke (6.9% [95% CI: 4.9%-9.6%]), ESUS (8.1% [95% CI: 3.4%-18.1%]), and IS (9.4% [95% CI: 7.5%-11.8%]). CONCLUSIONS: Abnormal TEE findings may decisively affect the selection of appropriate therapeutic strategy in approximately 1 of 7 patients with ESUS.

From the Department of Neurology St Anne's University Hospital in Brno Czech Republic

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Neurology. 87(10):972. PubMed

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The value of transesophageal echocardiography for embolic strokes of undetermined source

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