Cardiac microembolism: prevalence and clinical outcome

High intensity transient signals (HITS) have been identified ultrasonically in patients with extracranial vascular or cardiac disease and are suggestive of microembolic material. We studied the prevalence of these signals in 60 patients with increased risk for cardioembolic stroke and in a control g...

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Published inJournal of the neurological sciences Vol. 136; no. 1; pp. 143 - 147
Main Authors Eicke, B.Martin, Barth, Viola, Kukowski, Bornes, Werner, Gerald, Paulus, Walter
Format Journal Article
LanguageEnglish
Published Shannon Elsevier B.V 01.03.1996
Elsevier Science
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ISSN0022-510X
1878-5883
DOI10.1016/0022-510X(95)00299-H

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Abstract High intensity transient signals (HITS) have been identified ultrasonically in patients with extracranial vascular or cardiac disease and are suggestive of microembolic material. We studied the prevalence of these signals in 60 patients with increased risk for cardioembolic stroke and in a control group of 20 subjects. Patient groups ( n = 20) were characterized by either non-rheumatic atrial fibrillation (AFIB) (I) or a history of prosthetic valve surgery with AFIB (II) or without AFIB (III). Embolic signals were not seen in the control group. In group I, 3 patients (15%) demonstrated HITS, in groups II and III 10 patients (50%). Microembolic signals in patients with prosthetic heart valves (II, III) had a higher signal intensity, indicating different embolic material. There was no correlation of microembolic signals with the anticoagulant treatment or the position of the prosthetic valve. HITS were found in 1 9 (11%) of the patients with a bioprosthetic valve as compared to 19 31 (61%) with a mechanical valve. After 6–12 months, 1 of 12 HITS positive patients had experienced a stroke and 2 had died. None of the 28 patients without HITS had suffered a stroke, 2 had died. Microembolic signals are frequent events in patients with mechanical prosthetic valves. In these patients they do not appear to be a major prognostic factor for an impending cardioembolic stroke.
AbstractList High intensity transient signals (HITS) have been identified ultrasonically in patients with extracranial vascular or cardiac disease and are suggestive of microembolic material. We studied the prevalence of these signals in 60 patients with increased risk for cardioembolic stroke and in a control group of 20 subjects. Patient groups (n = 20) were characterized by either non-rheumatic atrial fibrillation (AFIB) (I) or a history of prosthetic valve surgery with AFIB (II) or without AFIB (III). Embolic signals were not seen in the control group. In group I, 3 patients (15%) demonstrated HITS, in groups II and III 10 patients (50%). Microembolic signals in patients with prosthetic heart valves (II, III) had a higher signal intensity, indicating different embolic material. There was no correlation of microembolic signals with the anticoagulant treatment or the position of the prosthetic valve. HITS were found in 1/9 (11%) of the patients with a bioprosthetic valve as compared to 19/31 (61%) with a mechanical valve. After 6-12 months, 1 of 12 HITS positive patients had experienced a stroke and 2 had died. None of the 28 patients without HITS had suffered a stroke, 2 had died. Microembolic signals are frequent events in patients with mechanical prosthetic valves. In these patients they do not appear to be a major prognostic factor for an impending cardioembolic stroke.
High intensity transient signals (HITS) have been identified ultrasonically in patients with extracranial vascular or cardiac disease and are suggestive of microembolic material. We studied the prevalence of these signals in 60 patients with increased risk for cardioembolic stroke and in a control group of 20 subjects. Patient groups ( n = 20) were characterized by either non-rheumatic atrial fibrillation (AFIB) (I) or a history of prosthetic valve surgery with AFIB (II) or without AFIB (III). Embolic signals were not seen in the control group. In group I, 3 patients (15%) demonstrated HITS, in groups II and III 10 patients (50%). Microembolic signals in patients with prosthetic heart valves (II, III) had a higher signal intensity, indicating different embolic material. There was no correlation of microembolic signals with the anticoagulant treatment or the position of the prosthetic valve. HITS were found in 1 9 (11%) of the patients with a bioprosthetic valve as compared to 19 31 (61%) with a mechanical valve. After 6–12 months, 1 of 12 HITS positive patients had experienced a stroke and 2 had died. None of the 28 patients without HITS had suffered a stroke, 2 had died. Microembolic signals are frequent events in patients with mechanical prosthetic valves. In these patients they do not appear to be a major prognostic factor for an impending cardioembolic stroke.
High intensity transient signals (HITS) have been identified ultrasonically in patients with extracranial vascular or cardiac disease and are suggestive of microembolic material. We studied the prevalence of these signals in 60 patients with increased risk for cardioembolic stroke and in a control group of 20 subjects. Patient groups (n = 20) were characterized by either non-rheumatic atrial fibrillation (AFIB) (I) or a history of prosthetic valve surgery with AFIB (II) or without AFIB (III). Embolic signals were not seen in the control group. In group I, 3 patients (15%) demonstrated HITS, in groups II and III 10 patients (50%). Microembolic signals in patients with prosthetic heart valves (II, III) had a higher signal intensity, indicating different embolic material. There was no correlation of microembolic signals with the anticoagulant treatment or the position of the prosthetic valve. HITS were found in 1/9 (11%) of the patients with a bioprosthetic valve as compared to 19/31 (61%) with a mechanical valve. After 6-12 months, 1 of 12 HITS positive patients had experienced a stroke and 2 had died. None of the 28 patients without HITS had suffered a stroke, 2 had died. Microembolic signals are frequent events in patients with mechanical prosthetic valves. In these patients they do not appear to be a major prognostic factor for an impending cardioembolic stroke.High intensity transient signals (HITS) have been identified ultrasonically in patients with extracranial vascular or cardiac disease and are suggestive of microembolic material. We studied the prevalence of these signals in 60 patients with increased risk for cardioembolic stroke and in a control group of 20 subjects. Patient groups (n = 20) were characterized by either non-rheumatic atrial fibrillation (AFIB) (I) or a history of prosthetic valve surgery with AFIB (II) or without AFIB (III). Embolic signals were not seen in the control group. In group I, 3 patients (15%) demonstrated HITS, in groups II and III 10 patients (50%). Microembolic signals in patients with prosthetic heart valves (II, III) had a higher signal intensity, indicating different embolic material. There was no correlation of microembolic signals with the anticoagulant treatment or the position of the prosthetic valve. HITS were found in 1/9 (11%) of the patients with a bioprosthetic valve as compared to 19/31 (61%) with a mechanical valve. After 6-12 months, 1 of 12 HITS positive patients had experienced a stroke and 2 had died. None of the 28 patients without HITS had suffered a stroke, 2 had died. Microembolic signals are frequent events in patients with mechanical prosthetic valves. In these patients they do not appear to be a major prognostic factor for an impending cardioembolic stroke.
Author Paulus, Walter
Eicke, B.Martin
Barth, Viola
Kukowski, Bornes
Werner, Gerald
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Issue 1
Keywords Stroke
Prosthetic heart valve
Transcranial doppler
Embolus detection
Ultrasound
Atrial fibrillation
Sonography
Doppler ultrasound study
Human
Nervous system diseases
Prevalence
Arrhythmia
Cardiovascular disease
Exploration
Valve prosthesis
Medical screening
Heart valve
Excitability disorder
Embolism
Cerebral disorder
Vascular disease
Transcranial route
Heart disease
Central nervous system disease
Cerebrovascular disease
Language English
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Snippet High intensity transient signals (HITS) have been identified ultrasonically in patients with extracranial vascular or cardiac disease and are suggestive of...
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StartPage 143
SubjectTerms Aged
Atrial fibrillation
Biological and medical sciences
Bioprosthesis - adverse effects
Cerebrovascular Disorders - diagnostic imaging
Cerebrovascular Disorders - epidemiology
Cerebrovascular Disorders - etiology
Coronary Disease - complications
Coronary Disease - diagnostic imaging
Coronary Disease - epidemiology
Electrocardiography
Embolus detection
Female
Heart Valve Prosthesis - adverse effects
Humans
Intracranial Embolism and Thrombosis - diagnostic imaging
Intracranial Embolism and Thrombosis - epidemiology
Intracranial Embolism and Thrombosis - etiology
Japan - epidemiology
Male
Medical sciences
Middle Aged
Neurology
Prosthetic heart valve
Stroke
Transcranial doppler
Treatment Outcome
Ultrasonography, Doppler, Transcranial
Ultrasound
Vascular diseases and vascular malformations of the nervous system
Title Cardiac microembolism: prevalence and clinical outcome
URI https://dx.doi.org/10.1016/0022-510X(95)00299-H
https://www.ncbi.nlm.nih.gov/pubmed/8815161
https://www.proquest.com/docview/15590864
https://www.proquest.com/docview/78100705
Volume 136
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