Neurologists Preferences on Basic and Advanced Cardiac Imaging Utilization in Ischemic Stroke Patients

Area of Science:

• Cardiology
• Neurology
• Medical Imaging

Background:

• Investigating cardioembolic sources in ischemic stroke patients is crucial for effective treatment.
• Current utilization patterns of cardiac imaging modalities by neurologists remain largely unknown globally.
• This study addresses the gap in understanding how neurologists employ various cardiac imaging techniques to detect cardioembolic stroke origins.

Discussion:

• Transthoracic echocardiography (TTE) is the most frequently utilized cardiac imaging study globally (71.2%).
• Transesophageal echocardiography (TEE) (15.8%), ECG-gated cardiac computed tomography (G-CCT) (10.9%), and cardiac magnetic resonance imaging (CMRI) (7.7%) show lower utilization rates.
• Computed tomography angiography (CTA) is increasingly used for acute ischemic stroke screening (71.6%), though often without ECG-gating for cardiac source detection.

Key Insights:

• A significant proportion of ischemic stroke patients evaluated across four continents do not undergo basic cardiac imaging.
• There is a notably low adoption rate of advanced cardiac imaging studies for identifying cardioembolic sources.
• Geographical consistency in imaging utilization suggests systemic rather than regional practice variations.

Outlook:

• The findings highlight a critical need for developing and implementing more accessible and efficient screening methods for cardioembolic sources.
• Future research should focus on strategies to improve the integration of cardiac imaging in the diagnostic workup of ischemic stroke.
• Enhanced guidelines and educational initiatives may be necessary to promote appropriate utilization of cardiac imaging in stroke neurology.