Mild Left Ventricular Dysfunction Is Associated with Thrombogenicity in Cardioembolic Stroke

Abstract

Background: Transesophageal echocardiography (TEE) has been recognized as a valuable tool for identifying the left cardiac thrombus (LCT) or spontaneous echocardiographic contrast (SEC). We aimed to identify risk groups where TEE should be performed in patients with suspected cardioembolic stroke according to magnetic resonance imaging analysis. Methods: One hundred and forty-six patients (mean age 64.7 ± 11.8 years, 101 males) with suspected cardioembolic stroke were analyzed. We used TEE for the presence of LCT and/or SEC as indication of thrombogenicity. We evaluated the association between thrombogenicity and demographic features, stroke risk factors and echocardiographic variables. Results: The study included 40 patients (27.3%) who showed thrombogenicity (10 LCT and 30 SEC). The independent echocardiographic variables of thrombogenicity were atrial fibrillation (OR 7.14; 95% CI 2.62–19.48; p < 0.001) and left ventricular ejection fraction ≤50% (OR 4.01; 95% CI 1.40–11.49; p = 0.01). Conclusion: We recommend that TEE should be considered in patients with mildly reduced left ventricular dysfunction (ejection fraction ≤50%) after suspected cardioembolic stroke.