Document Detail

Silent coronaropathy: usefulness of dobutamine stress echocardiography in ischemic stroke.
MedLine Citation:
PMID:  17057380     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Several testing options are available to detect asymptomatic coronary artery disease (CAD). Dobutamine stress echocardiography (DSE) has been reported to increase the sensitivity and specificity of stress testing to detect CAD. Most studies concerned patients with known or suspected CAD who have a high pretest probability of disease. We aimed to perform a preliminary evaluation of DSE in atherothrombotic stroke. METHODS: Patients with transient ischemic attack or nondisabling ischemic stroke attributable to an atherothrombotic source were prospectively recruited. Patients with a history of angina pectoris or electrocardiographic signs of previous myocardial infarction were excluded. DSE was considered positive when regional reduction or deterioration of myocardial thickening developed in 1 segment. Coronary angiography was performed in patients with positive DSE. RESULTS: Sixty-four patients were recruited. Analysis of DSE was possible in 60 patients. Overall the test provided clinically useful information in 60/64 patients studied (>90%). DSE was positive in 9 patients (15%). Coronary angiography was performed in 8 patients, high-grade focal lesions were found in 3 patients, and 5 patients showed diffuse atheroma. Univariate logistic regression analysis showed that the main factor predictive of a positive DSE was the presence of an aortic arch atheroma (p = 0.003). Multivariate logistic regression analysis showed that two factors had an independent predictive value of positive DSE: aortic arch atheroma (p = 0.007) and dyslipidemia (p = 0.09). CONCLUSION: DSE may improve prevention of further vascular events in patients with an atherothrombotic source of ischemic stroke. This screening may be of particular benefit to patients with an aortic arch atheroma.
Norbert Nighoghossian; Serkan Cakmak; Laurent Derex; Martine Barthelet; Hélène Thibault; Gérard Finet; Michel Ovize; Geneviève Derumeaux; Chantal Nemoz; François Chapuis; Gilles Rioufol
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2006-10-20
Journal Detail:
Title:  European neurology     Volume:  56     ISSN:  0014-3022     ISO Abbreviation:  Eur. Neurol.     Publication Date:  2006  
Date Detail:
Created Date:  2006-12-06     Completed Date:  2007-02-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0150760     Medline TA:  Eur Neurol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  211-6     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2006 S. Karger AG, Basel.
Cerebrovascular Unit, Hospital Pierre Wertheimer, Lyon, France.
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MeSH Terms
Aorta, Thoracic / pathology
Aortic Diseases / complications,  ultrasonography
Coronary Artery Disease / complications,  ultrasonography*
Echocardiography, Stress*
Magnetic Resonance Angiography
Mass Screening* / methods
Middle Aged
Myocardial Ischemia / etiology,  ultrasonography*
Stroke / etiology,  ultrasonography*

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