Related Experiment Videos
Cardiac abnormalities in ischemic cerebrovascular disease studied by two-dimensional echocardiography
Insights
Cardiac abnormalities like atrial fibrillation, rheumatic heart disease, hypertrophic cardiomyopathy, and mitral annulus calcification are significantly linked to embolic stroke. Nonrheumatic heart diseases also contribute to stroke risk.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Cerebral embolism is a significant cause of stroke.
- Identifying cardiac sources of embolism is crucial for stroke prevention.
Purpose of the Study:
- To investigate the prevalence of cardiac abnormalities in patients with ischemic cerebrovascular disease.
- To compare cardiac findings between stroke patients and controls.
Main Methods:
- Two-dimensional echocardiography was performed on 350 ischemic stroke patients and 350 controls.
- Electrocardiogram (ECG) was used to detect atrial fibrillation.
- Prevalence of structural cardiac diseases and intracardiac thrombi were compared.
Main Results:
- Atrial fibrillation was more common in stroke patients (33%) than controls (10%).
- Rheumatic heart disease, hypertrophic cardiomyopathy, and mitral annulus calcification were significantly more frequent in stroke patients.
- Intracardiac thrombi were diagnosed in 29% of patients versus 4% of controls.
Conclusions:
- Cardiac abnormalities, including nonrheumatic conditions like mitral annulus calcification and hypertrophic cardiomyopathy, are significant risk factors for embolic stroke.
- These findings highlight the importance of comprehensive cardiac evaluation in stroke patients.
Abstract:
In the study of cardiac abnormalities responsible for the development of cerebral embolism two-dimensional echocardiography was performed on 350 patients with ischemic cerebrovascular disease. The results were compared with those obtained from 350 controls without any history of stroke. Atrial fibrillation was detected on ECG in 115 cases (33%) of the patients and in 35 cases (10%) of the controls (p less than 0.001). The structural cardiac diseases observed in stroke patients were: rheumatic heart disease (RHD) in 37, congestive cardiomyopathy (CCM) in 7, hypertrophic cardiomyopathy (HCM) in 19, mitral annulus calcification (MAC) in 29, mitral valve prolapse (MVP) in 9, and myocardial infarction (MyI) in 10 patients. Controls were found to have these lesions in 11, 2, 3, 12, 4 and 9 patients respectively. RHD (p less than 0.001), HCM (p less than 0.01) and MAC (p less than 0.01) were significantly more frequent in patients with ischemic cerebrovascular disease, but not MyI, CCM or MVP. Intracardiac thrombi were diagnosed in 29 cases of patients and in 4 cases of controls (p less than 0.001). Our data suggested that nonrheumatic heart diseases such as MAC and HCM could also be considered as causes of embolic stroke. The reasons for the variable frequencies of cardiac abnormalities reported in the literature for stroke patients are discussed.