Echocardiographic Characteristics of Patients with Multiple Acute Concomitant Cerebral Infarcts

Background/Objectives: Only limited data on the characteristics and outcomes of patients with multiple acute concomitant cerebral infarcts (MACCI) exist. MACCI may imply a cardioembolic source and echocardiography is important in evaluating for potential embolic sources. However, data comparing echocardiographic features in MACCI to those observed in patients with single presumed embolic cerebral infarctions (SACI) are lacking. Thus, we aim to compare echocardiographic features between MACCI and SACI patients. Methods: We retrospectively analyzed data from a prospective stroke registry. The diagnosis of stroke secondary to MACCI and SACI was confirmed by MRI. Data on echocardiographic features, demographics, medical history, and functional status were extracted and compared between the groups. Results: Overall, 145 patients were included (83 SACI and 62 MACCI). MACCI patients were significantly older (mean ± sd 68.08 ± 13.04 vs. 62.70 ± 14.18; p = 0.021) and had higher rates of diabetes (35% vs. 25%; p = 0.014) and prior strokes (15% vs. 8%; p = 0.032). The only echocardiographic parameter that differed between the groups was left ventricular mass index (LVMI), which was significantly higher in the MACCI group after adjusting for age (aOR 1.02, 95% CI [1,1.04]; p = 0.042). MACCI was associated with higher mortality rates (34.4% vs. 18.1%, p = 0.041). No correlation was found between LVMI and stroke severity or outcomes. Conclusions: LVMI was significantly higher in MACCI patients, possibly reflecting undiagnosed hypertension, cardiomyopathy or systemic disease as potential thromboembolic mechanisms responsible for stroke. Larger studies are needed to further assess its potential role in the pathology of MACCI.