Shyu K G, Chen J J, Huang Z S, Hwang J J, Lee T K, Kuan P, Lien W P
Department of Emergency Medicine, Shin Kong Memorial Hospital, Taipei, Taiwan, ROC.
Cardiology. 1994;85(1):53-60. doi: 10.1159/000176646.
To evaluate the role of transesophageal echocardiography (TEE) in the diagnostic assessment of cardiac sources of embolism in acute ischemic stroke, 94 consecutive patients (44 men and 50 women, aged 22-82 years) with acute ischemic stroke were prospectively studied. Of these, 34 patients had clinical evidence of heart disease. Both transthoracic and transesophageal echocardiograms were recorded on the same day for each patient. Transthoracic echocardiography (TTE) identified a possible cardiac source of embolism in 2 patients (6%) with and in 3 (5%) without clinical heart disease. TEE identified a possible cardiac source of embolism in 21 patients (62%) with and in 18 (30%) without clinical heart disease. TEE was superior to TTE for the detection of a cardiac source of embolism in patients with acute ischemic stroke (41 vs. 5%, p < 0.001). Factors significantly associated with a greater likelihood of such cardiac sources of embolism included left atrial enlargement, atrial fibrillation and a younger age. The yield of TEE in identifying a possible cardiac source of embolism was higher in patients with clinical evidence of heart disease than in those without.
为评估经食管超声心动图（TEE）在急性缺血性卒中心脏栓塞源诊断评估中的作用，我们对94例连续的急性缺血性卒中患者（44例男性和50例女性，年龄22 - 82岁）进行了前瞻性研究。其中，34例患者有心脏病的临床证据。为每位患者在同一天记录经胸和经食管超声心动图。经胸超声心动图（TTE）在有临床心脏病的2例患者（6%）和无临床心脏病的3例患者（5%）中发现了可能的心脏栓塞源。TEE在有临床心脏病的21例患者（62%）和无临床心脏病的18例患者（30%）中发现了可能的心脏栓塞源。在急性缺血性卒中患者中，TEE在检测心脏栓塞源方面优于TTE（41%对5%，p < 0.001）。与这种心脏栓塞源可能性增加显著相关的因素包括左心房扩大、心房颤动和较年轻的年龄。有心脏病临床证据的患者中，TEE识别可能心脏栓塞源的检出率高于无心脏病证据的患者。
