Factors associated with abnormal cardiac magnetic resonance imaging in embolic stroke of undetermined source

Abstract

Dear Editor, Defining the underlying mechanism of ischemic stroke is one of the cornerstones of secondary prevention, but up to 42% are classified as embolic stroke of undetermined source (ESUS). 1-4 In this setting, cardiac magnetic resonance imaging (CMRI) has been proposed as a tool to further stratify patients with ESUS. 5-8 However, clinical predictors of these CMRI findings are not well studied, which may help to restrict a costlier investigation to high-risk subjects. We aimed to determine the prevalence of abnormalities found in CMRI in patients with ESUS; and to examine which variables are associated with the occurrence of such abnormalities. Consecutive patients admitted to an outpatient university-based stroke clinic were investigated for stroke etiologies using the Causative Classification of Stroke. Patients with ESUS were further investigated with CMRI, using a previously defined protocol. 9 The study was approved by the IRB and patients signed informed consent.

Cardiovascular MRI Compared to Echocardiography to Identify Cardioaortic Sources of Ischemic Stroke: A Systematic Review and Meta-Analysis

“…CMR is able to identify inherited or acquired cardiomyopathies that were missed by TTE in about 5% of patients with AIS (52). In regional areas with prevalent Chagas disease, CMR is able to identify left ventricle aneurysm and intracardiac thrombus in a relevant number of patients (79).…”