Abstract 16311: Echocardiographic Findings Predict Long-Term Mortality in Stroke Population
Introduction: Transthoracic echocardiography (TTE) has become a routine part of management for acute stroke to assess for cardiac sources of emboli. Many studies have illustrated a low diagnostic yield for sources of emboli on TTE, ranging from 3-10%. Little has been reported about the prognostic importance of TTE findings performed for evaluation of acute stroke.
Methods: Brain imaging and TTE reports were reviewed for 3,920 consecutive patients presenting to an urban medical center with acute stroke between 1/1/01 and 9/30/07. Data was collected on baseline demographics, subtypes of stroke, abnormal TTE findings, and 10-year rates of readmission for stroke and mortality. Brain imaging showed evidence of recent or old infarction in 2,501.
Results: Study patients were 67±15 years, 60% female, 75% minorities and had hypertension (75%), diabetes (41%), CKD (27%) and atrial fibrillation (18%). On TTE, a cardiac source (mass, thrombus or vegetation) was identified in only 14 cases (0.6%), whereas a clinically significant abnormality (EF<50%, LV or RV wall motion abnormality, severe valve disease, severe pulmonary hypertension, or severe LVH) was identified in 19%. Those with abnormal TTE at baseline had increased odds for death at 10-years (odds ratio 3.2 [95% CI: 2.6, 3.8], p<0.001), although odds for repeat admission with CVA were not increased (OR 1.0 [95% CI: 0.8, 1.3], p=0.9). Abnormal TTE remained associated with increased odds of death at 10-years after adjustment for age, sex, race, BMI, prior-MI and history of atrial fibrillation (OR 2.3 [95% CI: 1.7, 3.0], p<0.001).
Conclusions: Although TTE performed for ischemic stroke had minimal yield for identifying the source of embolization, clinically important abnormalities were common in this population. TTE abnormalities were independently associated with increased long-term mortality.
Author Disclosures: L. Garber: None. J.A. Miles: None. D.M. Spevack: None.
- © 2016 by American Heart Association, Inc.