EVALUATION OF SPONTANEOUS ECHOCONTRAST AND AORTIC ATHEROMA PLAQUES WITH TRANSESOPHAGEAL ECHOCARDIOGRAPHY iN PA TIENTS WITH ISCHEMIC STROKE

Aims: Transthoracic echocardiography (TTE) and Carotic-vertebral artery doppler (Doppler) findings were compared in patients with spontaneous echo contrast {SEC) and/or aortic atheroma plaques (AAP), which were detected by transesophagial echocardiography (TEE) used to investigate cardioembolic risk in ischemic stroke patients. Materials and Methods: 640 ischemic stroke patients followed by our dink were evaluated, and among 230 of the patients for whom TEE was required following TIE, 37 patients who had SEC and/or AAPs by TEE were included in the study. Ali patients underwent Doppler exarnination. SEC and/or AAPs detected by TEE were compared with findings of TIE and Doppler. Results: in 37 patients evaluated, 14 {38%) were found to have AAP (Group 1), 10 (27%) SEC (Group 2), 9 (24%) AAP + SEC (Group 3), 3 (8%) SEC + thrombus (Group 4), and 1 (3%) SEC + AAP + thrornbus (Group 5). Among the AAP's, type 3 AAP was found to be predorninant (71.4%). TIE results were normal in ali patients with AAP. Left atrial dilatation (LAD) was detected in ali patients with SEC, SEC + thrombus, and SEC + thrombus + AAP, and in 78% of patients with SEC+AAP. Conclusion: in our study on patients who underwent TIE in order to evaluate risk of cardioembolic stroke, patients with anormal TIE or with TIE detected LAD were shown to have SEC and/or AAP by TEE. The importance of TEE in detecting SEC and AAPs which are serious risk factors for stroke patients was discussed in the light of literature findings.

İSKEMİK İNMELİ HASTALARDA TRANSÖZEFAGİAL EKOKARDİYOGRAFİDE SPONTAN EKOKONTRAST VE AORTİK ATEROM PLAKLARININ DEGERLENDİRİLMESİ

Amaç: lskemik inmeli hastalarda, kardiyoembolik risk faktörü araştırmak amacıyla yapılan Transesofagial Ekokardiyografide (TEE), Spontan ekokontrast (SEK) ve /veya Aortik aterom plaklan (AAP) saptanan hastalarda Transtorasik ekokardiyografi (TTE) ve Karotis-vertebral arter doppler (Doppler) bulgularının karşılaştırılması yapılmıştır. Materyal- Metod: Kliniğimizde takip edilen 640 iskemik inmeli hasta değerlendirilerek TIE sonrası, TEE istenen 230 hastadan SEK ve /veya AAP saptanan 37'si çalışmaya alındı. Her hastaya Doppler tetkiki yapıldı. TEE'de saptanan SEK ve/veya AAP'ler TIE ve Doppler bulguları ile karşılaştırıldı. Bulgular: 37 hastanın 14'ünde (% 38) AAP(Grup 1), lO'unda (% 27) SEK (Grup 2), 9'unda (% 24) AAP + SEK (Grup 3), 3'ünde (% 8) SEK + trombüs (Grup 4), 1 'inde (% 3) SEK + AAP + trombüs (Grup 5) saptandı. AAP'ler içinde en fazla oranda (% 71.4) tip 3 AAP'na rastlandı. TIE bulguları, AAP olanların hepsinde normaldi. Sol atrial dilatasyon (SAD), SEK + AAP'lerin % 78'inde, SEK olanların, SEK + trombüs, SEK + trombüs + AAP olanların hepsinde mevcuttu. Sonuç: Çalışmamızda, kardiyoembolik inme için risk faktörü araştırılmasında, TTE'si normal veya TIE'de SAD saptanan hastalarda, TEE'de SEK ve /veya AAP saptandı. İnmeli hastalarda ciddi risk faktörü olan SEK ve AAP'leri saptamada TEE'nin önemi literatür bulguları ışığında tartışıldı.