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Heart Brain Clinic: An Integrated Approach to Stroke Care.

Muhammad Bilal Tariq1, Syed Kalimullah S Qadri1, Anjail Sharrief1

  • 1Department of Neurology (MBT), University of Texas Health Science Center at Houston; Department of Neurology (SKSQ), University of California Los Angeles; Department of Neurology and Stroke Institute (AS, KT, MO, BM), University of Texas Health Science Center at Houston; Department of Cardiology (AD, SG, MJL, RWS), University of Texas Health Science Center at Houston; and Department of Neurology (NG), University of Colorado Anschutz Medical Campus.

Neurology. Clinical Practice
|March 18, 2024
PubMed
Summary

A new Heart Brain Clinic (HBC) streamlines care for patent foramen ovale (PFO)-associated stroke patients, reducing clinic visits. This multidisciplinary approach may enhance care quality for younger stroke patients.

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Area of Science:

  • Neurology
  • Cardiology
  • Vascular Medicine

Background:

  • Patent foramen ovale (PFO) is associated with stroke, particularly in younger individuals.
  • Management requires coordinated care between cardiology and neurology specialists.
  • Multidisciplinary clinics can improve patient outcomes and care efficiency.

Purpose of the Study:

  • To evaluate the feasibility and impact of a multidisciplinary Structural Heart Brain Clinic (HBC) for patients with PFO-associated stroke.
  • To compare the efficiency and decision-making process for PFO closure in patients managed through the HBC versus standard care.

Main Methods:

  • Retrospective collection of demographic and clinical data for patients with PFO-associated ischemic stroke.
  • Comparison of a standard care group with a group managed by the Structural HBC.
  • Analysis of outcomes including time to PFO closure and number of clinic visits, using nonparametric and chi-square tests.

Main Results:

  • The Structural HBC managed 79 patients, compared to 41 in the standard care group.
  • HBC patients required significantly fewer clinic visits before a PFO closure decision (p = 0.001).
  • Clinicians were more likely to recommend against PFO closure in the HBC group (p = 0.021), potentially due to selection bias.

Conclusions:

  • A multidisciplinary, patient-centered approach through the HBC is feasible for managing PFO-associated stroke.
  • This model may improve the quality of care for younger patients with PFO-associated stroke.
  • Further research is needed to confirm improvements in broader care aspects and long-term outcomes.