Cihat UZUNKÖPRÜ, Enise Nur ÖZLEM TİRYAKİ, Muhammed Mücahit TİRYAKİ

The Relationship Between Transthoracic Echocardiography Findings, Localization of Stroke, and Risk Factors in Patients With Ischemic Stroke

Objective: Ischemic stroke is one of the common neurological pathology. Identifying the risk factors and treating cardiac pathologies play an important role in preventing ischemic stroke stroke. In this study, we aimed to examine the relationship between transthoracic echocardiography findings, localization of ischemia and the etiology of stroke. Methods: We included 149 patients with ischemic stroke who were followed up at Neurology Department of İzmir Katip Çelebi University Atatürk Training and Research Hospital between January 2018-January 2019. Demographic characteristics of the patients, etiology and localization of stroke, presence of cardiac arrhythmias, and transthoracic electrocardiography findings were recorded and the relationship between these parameters were examined. Results: We enrolled 81 female (54.4%) and 68 male (45.6%) patients in this study. The mean age was 68.0312.35. 84.6% of the patients have atherosclerotic and15.4% have cardioembolic stroke. The most common risk factor was hyperlipidemia. Atrial fibrillation was detected in 21.1% of the patients. While atrial fibrillation was more common in patients with cardioembolic stroke, smoking was more common in patients with atherosclerotic stroke. Although most patients had multiple risk factors prior to stroke, almost half of the patients did not use any antiaggregant or anticoagulant therapy. Cardioembolic strokes were positively correlated with greater left atrium width. There was no correlation between transthoracic electrocardiography findings and stroke location. Conclusion: Determination of risk factors in patients with ischemic stroke, investigation of cardiac pathologies, and applying appropriate treatments are important in terms of preventing both new and recurrent stroke development.

İskemik İnmeli Hastalarda Transtorasik Ekokardiografi Bulguları ile İnme Lokalizasyonu ve Risk Faktörleri Arasındaki İlişki

Giriş: İskemik inme sık görülen nörolojik patolojilerden birisidir. Eşlik eden risk faktörlerinin ve kardiyak patolojilerin saptanması ve tedavi edilmesi hem yeni gelişimli hem de tekrarlayıcı bir inmenin engellenmesi açısından önemli yer tutar. Bu amaçla çalışmamızda inme geçiren hastaların Elektrokardiyografi bulguları ile inme özellikleri ve risk faktörleri arasındaki ilişkinin incelenmesi amaçlanmıştır. Yöntemler: Bu çalışmaya 2018-2019 yılları arasında İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi Nöroloji Kliniğinde ‘İskemik İnme’ tanısı alan 149 hasta dahil edildi. Hastaların demografik özellikleri, inmenin etyolojisi, lokalizasyonu, kardiyak aritmi varlığı ve Elektrokardiyografi bulguları kayıt altına alındı ve bu parametrelerin birbirleri ile olan ilişkileri incelendi. Bulgular: Çalışmaya alınan 81’i kadın (%54.4) ve 68’i erkek (%45.6) olmak üzere toplam 149 hastanın yaş ortalamaları 68.0312.35’ti. Hastaların %84.6’sı aterosklerotik doğada inme geçirirken %15.4 hastada kardiyoembolik inme saptandı. En sık görülen risk faktörü %89.9 hastada görülen hiperlipidemi idi. Hastaların %21.1’inde atriyal fibrilasyon saptandı. Kardiyoembolik inme geçiren hastalarda atriyal fibrilasyon daha sık izlenirken aterosklerotik inmeli hastalarda sigara kullanımı daha sık izlendi. Hastaların yaklaşık yarısının inme geçirmeden önce çoklu risk faktörü içermesine karşın herhangi bir antiagregan ya da antikoagülan tedavi kullanmadığı görüldü. Sol atriyum genişliği fazla olan hastalarda kardiyoembolik inmelerin daha sık olduğu gözlendi. Elektrokardiyografi bulguları ile inme lokalizasyonu açısından herhangi bir ilişki ise saptanmadı. Sonuç: İskemik inmeli hastalarda risk faktörlerinin tayini, kardiyak patolojilerin derinlemesine araştırılması ve gerekli tedavilerin uygulanması hem yeni inme hem de tekrarlayıcı inme gelişiminin önüne geçmek açısından önemli yer tutmaktadır.

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