Novel echocardiographic indicator for potential cardioembolic stroke

Area of Science:

• Cardiology
• Neurology
• Medical Imaging

Background:

• Cardioembolic strokes (CS) have high mortality, yet their embolic sources often remain uncertain.
• Atrial fibrillation (AF) is a common cause, but other factors may contribute to CS.
• Transthoracic echocardiography (TTE) is crucial for evaluating cardiac function in stroke patients.

Purpose of the Study:

• To identify novel echocardiographic indicators for detecting potential cardioembolic stroke (PCS).
• To assess the added value of TTE findings beyond established risk factors like AF.
• To improve the diagnostic accuracy for CS etiology.

Main Methods:

• 1601 patients with acute ischemic stroke undergoing TTE were analyzed.
• Patients were classified into potential cardioembolic stroke (PCS) and non-PCS groups based on MRI.
• Logistic regression was used to evaluate TTE parameters, including the E/A ratio, for PCS prediction.

Main Results:

• 32.4% of patients had PCS; approximately half of these had AF.
• PCS patients exhibited larger left ventricular and atrial dimensions and reduced ejection fraction.
• An E/A ratio ≥1.5 independently predicted PCS (OR 2.89, P < 0.01) after adjusting for AF and other variables.

Conclusions:

• An E/A ratio ≥1.5 is a significant independent predictor of PCS.
• This echocardiographic finding provides incremental prognostic value for identifying CS.
• The E/A ratio aids in detecting cardioembolic sources beyond AF.