Clinical impact of transesophageal echocardiography in patients with stroke without clinical evidence of cardiovascular sources of emboli

Tatani, Solange Bernardes; Fukujima, Márcia Maiumi; Lima, João A.C.; Ferreira, Luiz Darcy Cortez; Ghefter, Cláudia G. Monaco; Prado, Gilmar Fernandes do; Babayan, Zara; Azevedo, Lyamara Apostólico de

doi:10.1590/s0066-782x2001000600003

Cited by 10 publications

(13 citation statements)

References 25 publications

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“…We found seven similar published studies (Leung et al 1995; Warner and Momah 1996; Palazzuoli 2000; Cabral et al 2001; Tatani 2001; Ward 2006; Harloff 2006; Table 3). Only one of them was prospective (Harloff 2006), three included patients without a previous TTE (Warner and Momah 1996; Palazzuoli 2000; Tatani 2001), and two included patients with atrial fibrilation (Warner and Momah 1996; Harloff 2006).…”

Section: Discussionsupporting

confidence: 74%

“…Only one of them was prospective (Harloff 2006), three included patients without a previous TTE (Warner and Momah 1996; Palazzuoli 2000; Tatani 2001), and two included patients with atrial fibrilation (Warner and Momah 1996; Harloff 2006). Only two of the studies specified the number of patients who had simultaneous patent foramen ovale and atrial septal aneurysm (Tatani 2001; Harloff 2006). This fact is relevant, since anticoagulation is considered beneficial only in patients with both these abnormalities (Mas et al 2001; Kizer et al 2005).…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

Abreu

Mateus²,

Carreteiro³

et al. 2008

Vasc Health Risk Manag

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Background:The role of transesophageal echocardiography (TEE) in the evaluation of acute stroke patients is still ill-defi ned. We conducted a prospective observational study to fi nd the prevalence of TEE fi ndings that indicate anticoagulation as benefi cial, in acute ischemic stroke patients without indication for anticoagulation based on clinical, electrocardiographic and transthoracic echocardiography (TTE) fi ndings. Methods:We prospectively studied all patients referred to our laboratory for TTE and TEE. Patients were excluded if the diagnosis was not acute ischemic stroke or if they had an indication for anticoagulation based on clinical, electrocardiographic, or TTE data. Patients with TEE fi ndings that might indicate anticoagulation as benefi cial were identifi ed. Results: A total of 84 patients with acute ischemic stroke and without indication for anticoagulation based on clinical and electrocardiographic or TTE data were included in the study. Findings indicating anticoagulation as benefi cial were found in 32.1%: spontaneous echo contrast (1.2%), complex aortic atheroma (27.4%), thrombus (8.3%), and simultaneous patent foramen ovale and atrial septal aneurysm (2.4%). Conclusions:The results of our study show that TEE can have therapy implications in 32.1% of ischemic stroke patients in sinus rhythm and with TTE with no indication for anticoagulation.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

Abreu

Mateus²,

Carreteiro³

et al. 2008

Vasc Health Risk Manag

View full text Add to dashboard Cite

show abstract

“…This finding that echocardiography is associated with a change in management in 74% of stroke patients is higher than in previous reports, 7,14 most likely because the current study evaluated both the prescription of new anticoagulation and new cardiac medications, whereas previous research focused on anticoagulation only. By limiting the focus to anticoagulation, earlier studies often suggested that echocardiography is overused in stroke patients, because echocardiography is associated with a new prescription for anticoagulation in a minority of patients.…”

Section: Discussioncontrasting

confidence: 62%

Echocardiography in stroke and the prescription of new anticoagulation and cardiac medications: A pilot project

Bravata

Concato

Kim

et al. 2004

Journal of Stroke and Cerebrovascular Diseases

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“…Only one of them was prospective (Harloff 2006), three included patients without a previous TTE (Warner and Momah 1996;Palazzuoli 2000;Tatani 2001), and two included patients with atrial fi brilation (Warner and Momah 1996;Harloff 2006). Only two of the studies specifi ed the number of patients who had simultaneous patent foramen ovale and atrial septal aneurysm (Tatani 2001;Harloff 2006). This fact is relevant, since anticoagulation is considered benefi cial only in patients with both these abnormalities (Mas et al 2001;Kizer et al 2005).…”

Section: Resultsmentioning

confidence: 99%

Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

Abreu¹

2008

VHRM

View full text Add to dashboard Cite

Background:The role of transesophageal echocardiography (TEE) in the evaluation of acute stroke patients is still ill-defi ned. We conducted a prospective observational study to fi nd the prevalence of TEE fi ndings that indicate anticoagulation as benefi cial, in acute ischemic stroke patients without indication for anticoagulation based on clinical, electrocardiographic and transthoracic echocardiography (TTE) fi ndings. Methods: We prospectively studied all patients referred to our laboratory for TTE and TEE. Patients were excluded if the diagnosis was not acute ischemic stroke or if they had an indication for anticoagulation based on clinical, electrocardiographic, or TTE data. Patients with TEE fi ndings that might indicate anticoagulation as benefi cial were identifi ed. Results: A total of 84 patients with acute ischemic stroke and without indication for anticoagulation based on clinical and electrocardiographic or TTE data were included in the study. Findings indicating anticoagulation as benefi cial were found in 32.1%: spontaneous echo contrast (1.2%), complex aortic atheroma (27.4%), thrombus (8.3%), and simultaneous patent foramen ovale and atrial septal aneurysm (2.4%). Conclusions:The results of our study show that TEE can have therapy implications in 32.1% of ischemic stroke patients in sinus rhythm and with TTE with no indication for anticoagulation.

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Clinical impact of transesophageal echocardiography in patients with stroke without clinical evidence of cardiovascular sources of emboli

Abstract: Objective -

Cited by 10 publications

References 25 publications

Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

Echocardiography in stroke and the prescription of new anticoagulation and cardiac medications: A pilot project

Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

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