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 in | Journal of the neurological sciences Vol. 136; no. 1; pp. 143 - 147 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Shannon
Elsevier B.V
01.03.1996
Elsevier Science |
Subjects | |
Online Access | Get full text |
ISSN | 0022-510X 1878-5883 |
DOI | 10.1016/0022-510X(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. |
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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 |
Author_xml | – sequence: 1 givenname: B.Martin surname: Eicke fullname: Eicke, B.Martin organization: Department of Clinical Neurophysiology, Georg-August-University, Robert-Koch-Str. 40 D-37075 Göttingen, Germany – sequence: 2 givenname: Viola surname: Barth fullname: Barth, Viola organization: Department of Clinical Neurophysiology, Georg-August-University, Robert-Koch-Str. 40 D-37075 Göttingen, Germany – sequence: 3 givenname: Bornes surname: Kukowski fullname: Kukowski, Bornes organization: Department of Clinical Neurophysiology, Georg-August-University, Robert-Koch-Str. 40 D-37075 Göttingen, Germany – sequence: 4 givenname: Gerald surname: Werner fullname: Werner, Gerald organization: Department of Internal Medicine, Georg-August-University, Göttingen, Germany – sequence: 5 givenname: Walter surname: Paulus fullname: Paulus, Walter organization: Department of Clinical Neurophysiology, Georg-August-University, Robert-Koch-Str. 40 D-37075 Göttingen, Germany |
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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 |
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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 |
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