Results of a focused cardiac ultrasound program conducted by neurologists within a stroke care network with cardiac imaging units

Abstract

Introduction and objectives: Recently, neurologists have begun to perform focused cardiac ultrasound for the detection of a cardiac source of embolism in stroke patients, requiring them to undergo a prior accredited training process. We designed a prospective study to analyze the incidence of heart disease detected by a focused cardiac ultrasound program within a stroke care network with cardiac imaging units and to identify the outcomes of detected structural heart disease at 1 year of follow-up.

Methods: We included patients admitted to a university hospital for ischemic stroke or a transient ischemic attack between 2017 and 2021 who were evaluated by focused cardiac ultrasound. We studied the presence of structural heart disease and cardioembolic sources. We analyzed cardiovascular events (CVE) during the first year of follow-up.

Results: Focused cardiac ultrasound was performed in 706 patients. Structural heart disease was detected in 52.1% and a cardioembolic source in 31.9%. Adverse CVE occurred in 5.49% of the patients in the first year of follow-up. The presence of de novo structural heart disease was independently associated with a higher probability of adverse CVE (HR, 1.72; 95%CI, 1.01- 2.91; P=.046).

Conclusions: Focused cardiac ultrasound within a stroke care network with cardiac imaging units is an accessible technique with high diagnostic yield. Its use allows clinical and therapeutic actions in the prevention of stroke recurrences and other CVEs in this group of patients.

Keywords: Anticoagulación; Anticoagulation; Cardiopatía; Cardiovascular disease; Diagnosis; Diagnóstico; Ecocardiografía transesofágica; Ecocardiografía transtorácica; Ecocardioscopia; Embolia cerebral; Embolic stroke; Enfermedad cardiovascular; Focused cardiac ultrasound; Heart disease; Ictus; Prevención; Prevention; Stroke; Transesophageal echocardiography; Transthoracic echocardiography.