Journals / Türk Serebrovasküler Hastalıklar Dergisi / 2004 / Cilt: 10 - Sayı: 2
Evaluation of spontaneous echocontrast and aortic atheroma plaques with transesophageal echocardiography in patients with ischemic stroke
- Pages
- 81–85
- DOI
- —
Abstract
Aims: Transthoracic echocardiography (TTE) and Carotic-vertebral artery doppler (Doppler) findings were compared in patients with spontaneous echo contrast (SEC) and/or aortic atheroma plaques (AAP), which were detected by transesophagial echocardiography (TEE) used to investigate cardioembolic risk in ischemic stroke patients. Materials and Methods: 640 ischemic stroke patients followed by our clinic were evaluated, and among 230 of the patients for whom TEE was recjuired following TTE, 37 patients who had SEC and/or AAPs by TEE were included in the study. All patients underwent Doppler examination. SEC and /or AAPs detected by TEE were compared with findings of TTE and Doppler. Results: In 37 patients evaluated, 14 (38%) were found to have AAP (Group 1), 10 (27%) SEC (Group 2), 9 (24%) AAP + SEC (Group 3), 3 (8%) SEC + thrombus (Group 4), and 1 (3%) SEC + AAP + thrombus (Group 5). Among the AAP's, type 3 AAP was found to be predominant (71.4%). TTE results were normal in all patients with AAP. Left atrial dilatation (LAD) was detected in all patients with SEC, SEC + thrombus, and SEC + thrombus + AAP, and in 78% of patients with SEC + AAP. Conclusion: In our study on patients who underwent TTE in order to evaluate risk of cardioembolic stroke, patients with a normal TTE or with TTE detected LAD were shown to have SEC and/or AAP by TEE. The importance of TEE in detecting SEC and AAPs which are serious risk factors for stroke patients was discussed in the light of literature findings.
Özet
Amaç: Iskemik inmeli hastalarda, kardiyoembolik risk faktörü araştırmak amacıyla yapılan Transesofagial Ekokardiyografide (TEE), Spontan ekokontrast (SEK) ve /veya Aortik aterom plakları (AAP) saptanan hastalarda Transtorasik ekokardiyografi (TTE) ve Karotis-vertebral arter doppler (Doppler) bulgularının karşılaştırılması yapılmıştır. Materyal- Metod: Kliniğimizde takip edilen 640 iskemik inmeli hasta değerlendirilerek TTE sonrası, TEE istenen 230 hastadan SEK ve /veya AAP saptanan 37'si çalışmaya alındı. Her hastaya Doppler tetkiki yapıldı. TEE'de saptanan SEK ve/veya AAPTer TTE ve Doppler bulguları ile karşılaştırıldı. Bulgular: 37 hastanın 14'ünde (% 38) AAP(Grup 1), 10'unda (% 27) SEK (Grup 2), 9'unda (% 24) AAP + SEK (Grup 3), 3'ünde (% 8) SEK + trombüs (Grup 4), l'inde (% 3) SEK + AAP + trombüs (Grup 5) saptandı. AAPTer içinde en fazla oranda (% 71.4) tip 3 AAP'na rastlandı. TTE bulguları, AAP olanların hepsinde normaldi. Sol atrial dilatasyon (SAD), SEK + AAPTerin % 78'inde, SEK olanların, SEK + trombüs, SEK + trombüs + AAP olanların hepsinde mevcuttu. Sonuç: Çalışmamızda, kardiyoembolik inme için risk faktörü araştırılmasında, TTE'si normal veya TTE'de SAD saptanan hastalarda, TEE'de SEK ve /veya AAP saptandı, inmeli hastalarda ciddi risk faktörü olan SEK ve AAP'leri saptamada TEE'nin önemi literatür bulguları ışığında tartışıldı.