Related Experiment Video
Updated: Apr 3, 2026
Real-Time Monitoring and Modulation of Blood Pressure in a Rabbit Model of Ischemic Stroke
Published on: February 10, 2023
Predictors of Ischemic Stroke in Rheumatic Heart Disease
Anirban Gupta1, Rohit Bhatia1, Gautam Sharma2
1Department of Neurology, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, New Delhi 110029, India.
Insights
Left atrial spontaneous echo contrast and atrial fibrillation (AF) are key predictors of ischemic stroke in rheumatic heart disease (RHD) patients. Identifying these risk factors is crucial for preventing strokes in this vulnerable population.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Rheumatic heart disease (RHD) is a significant cause of ischemic stroke.
- Predictors of stroke in RHD patients are not well-established, hindering targeted prevention strategies.
Purpose of the Study:
- To identify predictors of ischemic stroke in patients with RHD.
- To evaluate the 3-month functional outcomes of ischemic stroke in RHD patients.
Main Methods:
- A case-control study involving 40 adult RHD patients with ischemic stroke and 40 matched RHD controls without stroke history.
- Assessment of clinical profiles and functional outcomes using the modified Rankin scale.
Main Results:
- Left atrial spontaneous echo contrast (OR=39.9) and atrial fibrillation (AF) (OR=3.2) were significantly associated with ischemic stroke in RHD.
- Patients showed good outcomes with low mortality and improved modified Rankin scale scores at 3 months.
Conclusions:
- Atrial fibrillation and left atrial spontaneous echo contrast are significant risk factors for ischemic stroke in RHD.
- High prevalence of subclinical AF noted; further research into oral anticoagulation/antiplatelet agents is recommended for stroke prevention.
Background:
Studies on predictors of ischemic strokes caused by rheumatic heart disease (RHD) are sparse and extremely important for identifying high-risk cases to direct future therapeutic trials for prevention of ischemic stroke in this population.
Objective:
The aim of the present study was to study the predictors of ischemic stroke in patients with RHD and to observe outcome of patients with ischemic stroke at 3 months' follow-up using modified Rankin scale.
Methods:
We conducted a case-control study comparing the clinical profile of 40 adult patients with acute ischemic stroke caused by RHD with equal numbers of matched controls comprising patients with RHD without any prior history of stroke. We also observed the functional outcome of ischemic strokes in these patients.
Results:
The presence of left atrial spontaneous echo contrast (odds ratio = 39.9; 95% confidence interval, 3.16-501.9; P = .004) and atrial fibrillation (AF) (odds ratio = 3.2; 95% confidence interval, 1.6-6.7; P = .002) was significantly associated with stroke occurrence in RHD populations. The outcome of patients was good with low mortality and significant improvement of modified Rankin scale at 3 months' follow-up.
Conclusions:
Presence of AF and left atrial spontaneous echo contrast are significant risk factors for ischemic stroke in patients with RHD. There is high percentage of subclinical AF in this population. Future large clinical trials for oral anticoagulation/antiplatelet agents are needed for stroke prevention in high-risk RHD patients identified by a detailed workup.
Related Concept Videos
01:23Rheumatic Heart Disease I: Introduction
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:20Rheumatic Heart Disease IV: Nursing Management
01:21Rheumatic Heart Disease III: Medical Management
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:30Coronary Artery Disease I: Introduction