Assessment of Ischemic Stroke or Transient Ischemic Attack of Undetermined Cause Using Cardiac Magnetic Resonance Imaging

Abd Elmoneum, Mahmoud Shawky; Elderky, El Sayed Abd Elkhalek; Yousef, Amal Mohamed; Darwish, Mohamed Said

doi:10.21608/bmfj.2024.301311.2115

Assessment of Ischemic Stroke or Transient Ischemic Attack of Undetermined Cause Using Cardiac Magnetic Resonance Imaging

Articles in Press

Document Type : Original Article

Authors

¹ Assistant Professor of Cardiology, Faculty of Medicine, Benha University

² Professor of Cardiology, Faculty of Medicine, Benha University

³ (( msc) cardiology, Faculty of Medicine, Benha University)

⁴ Lecturer of Cardiology, Faculty of Medicine, Benha University

10.21608/bmfj.2024.301311.2115

Abstract

Background: After an ischemic stroke or transient ischemic attack (TIA), generally there is a diagnostic workup in search of the cause of the event, as this information may guide treatment that aims at reducing the risk of recurrent ischemic events. This study aimed to assess cardio embolic sources of acute ischemic stroke or transient ischemic attack of unknown cause by cardiac MRI (magnetic resonance imaging). Methods: This prospective non-randomized observational study included 100 patients exposed to acute ischemic stroke or transient ischemic attack. All cases were subjected to Full Clinical Examination (Cardiological and Neurological). Electrocardiogram (ECG). CT Brain or MRI Brain. Carotid Duplex Ultrasonography. Echocardiography (Echo). Laboratory Tests. Cardiac Magnetic Resonance Imaging (CMR). Results: There was a significant weak (fair) agreement between brain CT and brain MRI. By MRI examination, the LVSVI ranged from 40 to 48 mL/m2 with a mean of 43.96 ± 2.37 mL/m2. The RVSVI ranged from 35 to 54 mL/m2 with a mean of 49.3 ± 4.54 mL/m2. Conclusion: The data revealed various cardiac abnormalities such as left atrial enlargement, left atrial appendage thrombus, diastolic dysfunction, left ventricular tumors, thrombi, and patent foramen ovale, indicating a substantial prevalence of cardiac conditions that might contribute to stroke mechanisms. These findings underscore the importance of comprehensive cardiac evaluation in this patient population to better understand the cardioembolic sources of stroke, potentially leading to more targeted and effective treatment strategies.

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