London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 495 394 Heart and brain DO ALL THE INPATIENTS WITH UNDETERMINED STROKE NEED TO PERFORM A TRANSTHORACIC ECHOCARDIOGRAM? S. Arias-Rivas1, M. Rodríguez-Yáñez2, M. Santamaría-Cadavid3, G. Fernández-Pajarín4, J. Castil-lo5, M. Blanco6 Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Uni-versitario, IDIS, Santiago de Compostela, SPAIN1, Department of Neurology, Clinical Neurosci-ences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN2, Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Univer-sitario, IDIS, Santiago de Compostela, SPAIN3, Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN4, De-partment of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN5, Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN6 INTRODUCTION: From 15-30% of all ischemic strokes are cardioembolic. Transthoracic echo-cardiography (TTE) plays a key role in the evaluation, diagnosis and management of the embolic source. The absence of official recommendations for the use of TTE in patients with ischemic stroke leads to a universal application showing low diagnostic efficiency. Our objective is to analyze the diagnostic accuracy of TTE in patients with ischemic stroke in two situations: with universal indica-tion and after the application of previous defined risk clinical criteria (RCC). MATERIAL AND METHODS: We analyze ischemic stroke patients who had undergone TTE ac-cording to universal criteria during 2009-2011. We evaluated the presence of major embolic source (MES) in these patients. We defined RCC as the presence of age<60 years, abnormal basal ECG, cardiomegaly of chest radiography or previous history of heart disease, suspected endocarditis and/ or active neoplasia. We analyzed the presence of MES in these selected patients. We evaluated the sensibility and specificity of these criteria to detect MES. RESULTS: We included 930 patients with ischemic stroke. ETT was performed in 201 (9.95% had MES). Ninety-seven patients (18.55%) meet RCC (20.4% had MES). Only one patient (without RCC) showed cardioembolic source (aortic plaque). The proposed criteria have a sensitivity 94.7%, specificity 56.6%, positive predictive value 18.6% and negative predictive value of 99%. CONCLUSIONS: The application of RCC in hospitalized stroke patients help to identify cardioem-bolic sources postponing the test to an ambulatory scenario in the rest of the patients. 395 Heart and brain THE ASSOCIATION BETWEEN THE PRESENCE, INTENSITY OF PATENT FORAMEN OVALE AND THE LOCALIZATION OF STROKE I. Midi1, A. Pehlivan2, S. Ozsahin3, S. Aktan4, M. Sunbul5, B. Mutlu6, O. Cil7, O. Yasmut8, C. Mer-ic9, E. Ozer10, O. Korkut11 Marmara University Hospital, Department of Neurology, Istanbul, TURKEY1, Marmara Uni-versity Hospital, Department of Neurology, Istanbul, TURKEY2, Marmara University Hospital, Department of Neurology, Istanbul, TURKEY3, Marmara University Hospital, Department of Neu-rology, Istanbul, TURKEY4, Marmara University Hospital, Department of Cardiology, Istanbul, TURKEY5, Marmara University Hospital, Department of Cardiology, Istanbul, TURKEY6, Marmara University Hospital, Istanbul, TURKEY7, Marmara University Hospital, Istanbul, TURKEY8, Mar-mara University Hospital, Istanbul, TURKEY9, Marmara University Hospital, Istanbul, TURKEY10, Marmara University Hospital, Istanbul, TUR-KEY11 BACKGROUND Incidence of patent foramen ovale (PFO) is estimated at 25% in the general population and 6% for larger defects. Patent foramen ovale (PFO) is considered to be a risk factor for ischemic cerebrovas-cular disease (ICVD), especially in young people. The purpose of the present study is to evaluate the localization of stroke related to PFO in patients below 60 years of age. METHODS The patients admitted to our hospital by the reason of stroke between the years 2009 – 2012 June were included the study. There were 78 patients in total. Routine blood tests, vasculitis markes, cou-gulation and trombosis panels were sent and 12-lead electrocardiogram, 24-hour electrocardiogram Holter, contrast ECHO and TEE, extracranial Doppler ultrasonography, cranial CT and diffusion MR, and/or MR angiography were evaluated to exclude other etiologies. The localization of stroke was recorded as anterior or posterior circulation infarcts and lesion localization according to hemi-sphere, the number of lesion (single or multiple) were also noted. PFO intensity was determined as ‘+’ or ‘+++’ (+++ shows that the passage is more than 20 bubbles). RESULTS The mean age of 78 patients was 42.1 ( 28 – 60 ) and 53% of the patients were male. In terms of the localization of the strokes, posterior circulation infarcts were 40, anterior circulation infarcts were 25 and bilateral infarcts were 13 in total. The percentage of multiple infracts in a single hemisphere was higher . CONCLUSION PFO is reported as an etiology of stroke which is seen more frequently in young population. In the present study we found that posterior circulation infarcts ecpecially in PCA and cerebellum territo-ry are common in patients with PFO and also we found multiple infarcts in a single hemisphere is higher.
Karger_ESC London_2013
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