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Feasibility and Diagnostic Value of Cardiovascular Magnetic Resonance Imaging After Acute Ischemic Stroke of Undetermined Origin.
Haeusler, Karl Georg; Wollboldt, Christian; Bentheim, Laura Zu; Herm, Juliane; Jäger, Sebastian; Kunze, Claudia; Eberle, Holger-Carsten; Deluigi, Claudia Christina; Bruder, Oliver; Malsch, Carolin; Heuschmann, Peter U; Endres, Matthias; Audebert, Heinrich J; Morguet, Andreas J; Jensen, Christoph; Fiebach, Jochen B.
  • Haeusler KG; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Wollboldt C; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Bentheim LZ; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Herm J; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Jäger S; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Kunze C; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Eberle HC; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Deluigi CC; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Bruder O; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Malsch C; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Heuschmann PU; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Endres M; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Audebert HJ; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Morguet AJ; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Jensen C; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
  • Fiebach JB; From the Department of Neurology (K.G.H., C.W., L.z.B., J.H., M.E., H.J.A.) and Center for Stroke Research Berlin (K.G.H., C.K., M.E., H.J.A., J.B.F.), Charité - Universitätsmedizin Berlin, Germany; Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth-Krankenhaus, Es
Stroke ; 48(5): 1241-1247, 2017 05.
Article en En | MEDLINE | ID: mdl-28411261
ABSTRACT
BACKGROUND AND

PURPOSE:

Etiology of acute ischemic stroke remains undetermined (cryptogenic) in about 25% of patients after state-of-the-art diagnostic work-up.

METHODS:

One-hundred and three patients with magnetic resonance imaging (MRI)-proven acute ischemic stroke of undetermined origin were prospectively enrolled and underwent 3-T cardiac MRI and magnetic resonance angiography of the aortic arch in addition to state-of-the-art diagnostic work-up, including transesophageal echocardiography (TEE). We analyzed the feasibility, diagnostic accuracy, and added value of cardiovascular MRI (cvMRI) compared with TEE for detecting sources of stroke.

RESULTS:

Overall, 102 (99.0%) ischemic stroke patients (median 63 years [interquartile range, 53-72], 24% female, median NIHSS (National Institutes of Health Stroke Scale) score on admission 2 [interquartile range, 1-4]) underwent cvMRI and TEE in hospital; 89 (86.4%) patients completed the cvMRI examination. In 93 cryptogenic stroke patients, a high-risk embolic source was found in 9 (8.7%) patients by cvMRI and in 11 (11.8%) patients by echocardiography, respectively. cvMRI and echocardiography findings were consistent in 80 (86.0%) patients, resulting in a degree of agreement of κ=0.24. In 82 patients with cryptogenic stroke according to routine work-up, including TEE, cvMRI identified stroke etiology in additional 5 (6.1%) patients. Late gadolinium enhancement consistent with previous myocardial infarction was found in 13 (14.6%) out of 89 stroke patients completing cvMRI. Only 2 of these 13 patients had known coronary artery disease.

CONCLUSIONS:

Our study demonstrated that cvMRI was feasible in the vast majority of included patients with acute ischemic stroke. The diagnostic information of cvMRI seems to be complementary to TEE but is not replacing echocardiography after acute ischemic stroke. CLINICAL TRIAL REGISTRATION URL http//www.clinicaltrials.gov. Unique identifier NCT01917955.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Aorta Torácica / Imagen por Resonancia Magnética / Enfermedades Cardiovasculares / Isquemia Encefálica / Accidente Cerebrovascular Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2017 Tipo del documento: Article
Texto completo
Imprimir
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PubMed Links
Search on Google

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Aorta Torácica / Imagen por Resonancia Magnética / Enfermedades Cardiovasculares / Isquemia Encefálica / Accidente Cerebrovascular Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2017 Tipo del documento: Article