In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
Abstract:
Background: It is unclear whether biomarkers of cardiac dysfunction are associated with embolic stroke of undetermined source (ESUS), while large patent foramen ovale (PFO) could relate to it. Method: We retrospectively review patients with ischemic stroke who underwent transesophageal echocardiography (TEE) from April 2012, to April 2018. The peak transmitral filling velocity/early diastolic mitral annular tissue velocity (E/e’) on transthoracic echocardiography was used to estimate diastolic dysfunction. PFO and left atrial appendage (LAA) flow velocity were evaluated by TEE. We compared risk factors, clinical characteristics and biomarkers of cardiac dysfunction (brain natriuretic peptide [BNP], left atrial diameter, E/e’, the presence of systolic dysfunction [EF 〈 40%], and LAA flow velocity) adjusted for age and sex between ESUS with and without large PFO. We evaluated outcome at 90 days of ESUS patients who had biomarkers of cardiac dysfunction compared to that of ESUS patients with large PFO. Results: Among 294 patients with ESUS, 163 patients underwent TEE (55%). Of these, 24 patients (15%) had large PFO. Compared with ESUS patients with large PFO, those without large PFO had higher BNP (adjusted odds ratio 1.02, 95% confidence interval; 1.00-1.03, p=0.002) and higher E/e’ (1.25, 1.06-1.48; p=0.003). Left atrial diameter, EF 〈 40% and LAA flow velocity were similar between ESUS with and without large PFO groups. (p=0.165, p=0.622 and p=0.859). ESUS patients without large PFO with both BNP level 〉 50 pg/ml and E/e’ 〉 12, which were median values, had worse clinical outcome compared to patients who have less cardiac biomarkers and patients with large PFO. (p=0.005) Conclusion: ESUS Patients without large PFO often have biomarkers of cardiac dysfunction. The clinic outcome of ESUS patients without large PFO who have biomarkers of cardiac dysfunction could be worse than that of ESUS patients with large PFO.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/str.50.suppl_1.WP273
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
detail.hit.zdb_id:
1467823-8
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