Joonsang Yoo1, Dongbeom Song1, Jang-Hyun Baek1, Young Dae Kim1, Hyo Suk Nam1, Geu-Ru Hong1, Jinkwon Kim1, Hye Sun Lee1, Ji Hoe Heo2. 1. From the Department of Neurology (J.Y., D.S., J.-H.B., Y.D.K., H.S.N., J.K., J.H.H.), Cardiology Division, Severance Cardiovascular Hospital (G.-R.H.), and Biostatistics Collaboration Unit (H.S.L.), Yonsei University College of Medicine, Seoul, Korea; and Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (J.K.). 2. From the Department of Neurology (J.Y., D.S., J.-H.B., Y.D.K., H.S.N., J.K., J.H.H.), Cardiology Division, Severance Cardiovascular Hospital (G.-R.H.), and Biostatistics Collaboration Unit (H.S.L.), Yonsei University College of Medicine, Seoul, Korea; and Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (J.K.). jhheo@yuhs.ac.
Abstract
BACKGROUND AND PURPOSE: Spontaneous echo contrast (SEC) is frequently detected in patients with atrial fibrillation (AF). Coexisting SEC in patients with AF may be associated with heightened thrombogenicity, which affects stroke outcomes. METHODS: Consecutive stroke patients with nonvalvular AF who underwent transesophageal echocardiography were included in this study. We compared initial stroke severity and functional outcome at 3 months between the patients with and those without SEC. RESULTS: Of 440 patients with nonvalvular AF who underwent transesophageal echocardiography during a 7-year period, 193 (43.9%) patients had SEC. Stroke was more severe in the patients with SEC than in those without SEC (National Institute of Health Stroke Scale score: median [interquartile range], 5 [2-12] versus 3 [1-8]; P=0.004). The patients with SEC more frequently had poor functional outcomes (modified Rankin scale score of >2) at 3 months than those without SEC (32.3% versus 16.1%; P<0.001). On multivariate analysis, the presence of SEC was an independent factor of poor outcome (odds ratio, 2.09; 95% confidence interval, 1.24-3.53). CONCLUSIONS: In the ischemic stroke patients with nonvalvular AF, coexisting SEC was associated with more severe stroke and was predictive of poor long-term functional outcome.
BACKGROUND AND PURPOSE: Spontaneous echo contrast (SEC) is frequently detected in patients with atrial fibrillation (AF). Coexisting SEC in patients with AF may be associated with heightened thrombogenicity, which affects stroke outcomes. METHODS: Consecutive strokepatients with nonvalvular AF who underwent transesophageal echocardiography were included in this study. We compared initial stroke severity and functional outcome at 3 months between the patients with and those without SEC. RESULTS: Of 440 patients with nonvalvular AF who underwent transesophageal echocardiography during a 7-year period, 193 (43.9%) patients had SEC. Stroke was more severe in the patients with SEC than in those without SEC (National Institute of Health Stroke Scale score: median [interquartile range], 5 [2-12] versus 3 [1-8]; P=0.004). The patients with SEC more frequently had poor functional outcomes (modified Rankin scale score of >2) at 3 months than those without SEC (32.3% versus 16.1%; P<0.001). On multivariate analysis, the presence of SEC was an independent factor of poor outcome (odds ratio, 2.09; 95% confidence interval, 1.24-3.53). CONCLUSIONS: In the ischemic strokepatients with nonvalvular AF, coexisting SEC was associated with more severe stroke and was predictive of poor long-term functional outcome.
Authors: Julian Felix Backhaus; Andreas Pflaumbaum; Christos Krogias; Fabienne Kreimer; Andreas Mügge; Ralf Gold; Michael Gotzmann Journal: Clin Res Cardiol Date: 2021-08-26 Impact factor: 5.460