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Published on: February 10, 2013

Silent coronaropathy: usefulness of dobutamine stress echocardiography in ischemic stroke

Norbert Nighoghossian1, Serkan Cakmak, Laurent Derex

  • 1Cerebrovascular Unit, Hospital Pierre Wertheimer, Lyon, France. norbert.nighoghossian@chu-lyon.fr

European Neurology
|October 24, 2006
PubMed

Insights

Dobutamine stress echocardiography (DSE) shows promise in detecting coronary artery disease in patients with atherothrombotic stroke. Aortic arch atheroma and dyslipidemia are key predictors of positive DSE results, aiding in stroke prevention.

Area of Science:

  • Cardiology
  • Neurology
  • Diagnostic Imaging

Background:

  • Coronary artery disease (CAD) detection often involves various tests.
  • Dobutamine stress echocardiography (DSE) enhances sensitivity and specificity for CAD detection.
  • Previous studies focused on patients with high pretest probability of CAD.

Purpose of the Study:

  • To preliminarily evaluate the utility of DSE in patients experiencing atherothrombotic stroke.
  • To identify predictors of positive DSE findings in this patient cohort.

Main Methods:

  • Prospective recruitment of patients with transient ischemic attack or nondisabling ischemic stroke from atherothrombotic sources.
  • Exclusion of patients with a history of angina or signs of previous myocardial infarction.
  • DSE positivity defined by regional myocardial thickening reduction; coronary angiography performed for positive DSE.

Main Results:

  • DSE provided clinically useful information in over 90% of the 60 analyzed patients.
  • DSE was positive in 15% of patients; 38% of these showed high-grade lesions or diffuse atheroma on angiography.
  • Aortic arch atheroma and dyslipidemia independently predicted positive DSE results.

Conclusions:

  • DSE may enhance the prevention of subsequent vascular events in patients with atherothrombotic stroke.
  • Screening with DSE could be particularly beneficial for patients presenting with aortic arch atheroma.
Abstract

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