A Review of the Role of Transthoracic and Transesophageal Echocardiography, Computed Tomography, and Magnetic Resonance Imaging in Cardioembolic Stroke

Arnautu, Sergiu Florin; Arnautu, D A; Lascu, Ana; Hajevschi, Andrei A; Rosca, Ciprian Ilie; Sharma, Abhinav; Jianu, Dragoș Cătălin

doi:10.12659/msm.936365

Cited by 3 publications

(7 citation statements)

References 53 publications

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“…It is readily available, non-invasive, and cheaper than TOE [18]. TTE is also a first-line treatment used to identify infective endocarditis (sensitivity 62-79%), with TOE (sensitivity 85-90%) being used for indeterminate TTE findings and/or abscesses [19]. TTE is also highly sensitive and specific (with corresponding values of 96% and 90%, respectively, without contrast) for LV thrombus detection [20].…”

Section: Methodsmentioning

confidence: 99%

“…Both TTE and TOE are used in the identification of infective endocarditis. TTE has a sensitivity of 62-79%, and TOE has a sensitivity of 85-90% [19]. TOE is better for evaluating leaflet tears and abscesses [19].…”

Section: Tte Vs Toementioning

confidence: 99%

“…TTE has a sensitivity of 62-79%, and TOE has a sensitivity of 85-90% [19]. TOE is better for evaluating leaflet tears and abscesses [19]. In the detection of mitral and aortic valve prostheses, TOE is superior to TTE (TOE sensitivity: 80-90%; TTE sensitivity: 20-40%) [19].…”

Section: Tte Vs Toementioning

confidence: 99%

“…TOE is better for evaluating leaflet tears and abscesses [19]. In the detection of mitral and aortic valve prostheses, TOE is superior to TTE (TOE sensitivity: 80-90%; TTE sensitivity: 20-40%) [19]. In the detection of abscesses, TOE has higher sensitivity than TTE (87% vs. 28% respectively) but lower specificity (95% vs. 98%, respectively) [19].…”

Section: Tte Vs Toementioning

confidence: 99%

“…Readily available [25][26][27] Non-invasive [25][26][27] Inexpensive [25][26][27] Sensitive and specific for LV thrombus [20] Limited views of atria and appendages [26] Inter-operator variability [25][26][27] Potentially limited acoustic windows [25][26][27] TOE Gold standard for detecting high-risk and potential cardioembolic sources of stroke [28][29][30] Good views of atria and appendages [16,28,31] Better for evaluating leaflet tears and abscesses in IE [19] Can be considered for patients afflicted by cryptogenic stroke who may be reclassified as cardioembolic [34,35] Can be considered for younger patients in order to search for PFO [38][39][40] 26% of secondary prevention management modified by TOE results [34] Semi-invasive [44] Resource-heavy [45] Expensive [45] Minor procedural risks [45] Higher risk of complications in certain patient groups (high body weight, history of gastrointestinal bleed or surgery, advanced age, and oesophageal mass/stricture/varices) and patients with higher sedation risk (chronic kidney disease, cardiac disease, pulmonary disease, liver cirrhosis) [44] Role in the acute evaluation of ischaemic stroke is not well established [32,33] Inter-operator variability [45] Cardiac CT Better soft tissue characterisation …”

Section: Ttementioning

confidence: 99%

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Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review

Thong,

Kong,

Poh

et al. 2023

JCDD

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Cardioembolic strokes account for 20–25% of all ischaemic strokes, with their incidence increasing with age. Cardiac imaging plays a crucial role in identifying cardioembolic causes of stroke, with early and accurate identification affecting treatment, preventing recurrence, and reducing stroke incidence. Echocardiography serves as the mainstay of cardiac evaluation. Transthoracic echocardiography (TTE) is the first line in the basic evaluation of structural heart disorders, valvular disease, vegetations, and intraventricular thrombus. It can be used to measure chamber size and systolic/diastolic function. Trans-oesophageal echocardiography (TOE) yields better results in identifying potential cardioembolic sources of stroke and should be strongly considered, especially if TTE does not yield adequate results. Cardiac computed tomography and cardiac magnetic resonance imaging provide better soft tissue characterisation, high-grade anatomical information, spatial and temporal visualisation, and image reconstruction in multiple planes, especially with contrast. These techniques are useful in cases of inconclusive echocardiograms and can be used to detect and characterise valvular lesions, thrombi, fibrosis, cardiomyopathies, and aortic plaques. Nuclear imaging is not routinely used, but it can be used to assess left-ventricular perfusion, function, and dimensions and may be useful in cases of infective endocarditis. Its use should be considered on a case-by-case basis. The accuracy of each imaging modality depends on the likely source of cardioembolism, and the choice of imaging approach should be tailored to individual patients.

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Section: Methodsmentioning

confidence: 99%

Section: Tte Vs Toementioning

confidence: 99%

Section: Tte Vs Toementioning

confidence: 99%

Section: Tte Vs Toementioning

confidence: 99%

Section: Ttementioning

confidence: 99%

See 3 more Smart Citations

Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review

Thong,

Kong,

Poh

et al. 2023

JCDD

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Cardiac tissue engineering: an emerging approach to the treatment of heart failure

Rayat Pisheh,

Nojabaei,

Darvishi

et al. 2024

Front. Bioeng. Biotechnol.

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Heart failure is a major health problem in which the heart is unable to pump enough blood to meet the body’s needs. It is a progressive disease that becomes more severe over time and can be caused by a variety of factors, including heart attack, cardiomyopathy and heart valve disease. There are various methods to cure this disease, which has many complications and risks. The advancement of knowledge and technology has proposed new methods for many diseases. One of the promising new treatments for heart failure is tissue engineering. Tissue engineering is a field of research that aims to create living tissues and organs to replace damaged or diseased tissue. The goal of tissue engineering in heart failure is to improve cardiac function and reduce the need for heart transplantation. This can be done using the three important principles of cells, biomaterials and signals to improve function or replace heart tissue. The techniques for using cells and biomaterials such as electrospinning, hydrogel synthesis, decellularization, etc. are diverse. Treating heart failure through tissue engineering is still under development and research, but it is hoped that there will be no transplants or invasive surgeries in the near future. In this study, based on the most important research in recent years, we will examine the power of tissue engineering in the treatment of heart failure.

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A Dual Challenge: Coxiella burnetii Endocarditis in a Patient with Familial Thoracic Aortic Aneurysm—Case Report and Literature Review

Cozlac,

Streian,

Boca

et al. 2024

JCM

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Background/Objectives: Thoracic aortic aneurysms (TAAs) are potentially life-threatening medical conditions, and their etiology involves both genetic and multiple risk factors. Coxiella burnetii endocarditis is one of the most frequent causes of blood culture-negative infective endocarditis (BCNIE) in patients with previous cardiac surgery. Our review aims to emphasize the importance of genetic testing in patients with thoracic aortic aneurysms but also the importance of additional testing in patients with suspected endocarditis whose blood cultures remain negative. The reported case has a history of acute DeBakey type I aortic dissection that developed during her second pregnancy, for which the Bentall procedure was performed at that time. Ten years after the surgery, the patient started developing prolonged febrile syndrome with repeatedly negative blood cultures, the serological tests revealing the presence of an infection with Coxiella burnetii. Considering her family history and the onset of her aortic pathology at a young age, genetic tests were performed, disclosing a missense variant in the actin alpha-2 (ACTA2) gene in heterozygous status. Methods: For a better understanding of both conditions, our research was conducted in two directions: one reviewing the literature on patients with Coxiella burnetii BCNIE and the other focusing on patients who had a familial thoracic aortic aneurysm (FTAA) due to the ACTA2 variant. This review incorporates studies found on PubMed and ResearchGate up to August 2024. Conclusions: BCNIE represents a condition with several diagnostic challenges and may lead to severe complications if timely treatment is not initiated. Also, diagnosing an FTAA requires genetic testing, enabling better follow-up and management.

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A Review of the Role of Transthoracic and Transesophageal Echocardiography, Computed Tomography, and Magnetic Resonance Imaging in Cardioembolic Stroke

Cited by 3 publications

References 53 publications

Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review

Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review

Cardiac tissue engineering: an emerging approach to the treatment of heart failure

A Dual Challenge: Coxiella burnetii Endocarditis in a Patient with Familial Thoracic Aortic Aneurysm—Case Report and Literature Review

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