Publications by authors named "Beemsterboer C"
Background: Cardiac computed tomography (CT) is increasingly used to search for cardioembolic sources of acute ischemic stroke (AIS). We assessed the association between high-risk cardioembolic sources on cardiac CT and AIS.
Methods: We performed a case-control study using data from a prospective cohort including consecutive adult patients with suspected stroke who underwent cardiac CT acquired during the initial stroke imaging protocol between 2018 and 2020.
Article Synopsis
- This study investigates the impact of left atrial appendage (LAA) slow-flow on ischemic stroke outcomes, finding that 16% of patients had slow-flow and shared characteristics with those having LAA thrombus.
- While both slow-flow and thrombus were linked to a higher prevalence of atrial fibrillation, patients with thrombus experienced more severe strokes and worse functional outcomes than those with slow-flow.
- Ultimately, slow-flow did not significantly affect functional outcomes or major cardiovascular events, but it was associated with an increased risk of stroke recurrence in patients with unknown causes of their strokes.
Background: Cardiac computed tomography (CT) acquired during the initial acute stroke imaging protocol (acute cardiac CT) is increasingly used to screen for cardioembolism, but information on the long-term clinical implications of its findings is lacking.
Methods And Results: We performed a prospective, single-center cohort study in which consecutive patients with ischemic stroke underwent ECG-gated acute cardiac CT and were followed up for 2 years. The primary outcome was functional outcome assessed using the modified Rankin Scale.
Article Synopsis
- The study investigates the early dissolution of cardiac thrombi, which are often missed in imaging but can cause ischemic strokes.
- Five patients with acute ischemic strokes and cardiac thrombi were monitored with cardiac CT scans.
- Results indicated that some thrombi dissolved within days of the stroke, which could explain why they are rarely detected during initial imaging.
Article Synopsis
- Cardiac CT may provide a new alternative to transthoracic echocardiography (TTE) for screening cardiac issues related to ischemic strokes, especially for detecting patent foramen ovale (PFO).
- In a study involving 59 patients under 60 years, cardiac CT identified PFO in only 8% of cases, while TTE detected it in 20%, highlighting the limited effectiveness of cardiac CT in this context.
- The low sensitivity of cardiac CT prompts the need for additional echocardiography in young patients with unexplained strokes, and more extensive research is necessary to validate these findings.
Article Synopsis
- Cardiac thrombi, found in about 8% of patients with acute ischemic stroke, are often located in the left atrial appendage and are linked to more severe strokes and poor outcomes.
- In a study of 452 patients, those with cardiac thrombi had higher NIHSS scores (indicating more severe symptoms) and more complications like multiple vascular occlusions compared to those without.
- Although thrombi were associated with worse functional outcomes, the rate of stroke recurrence at 90 days was not significantly different between the two groups.
Background And Objectives: Guidelines recommend echocardiography to screen for structural sources of cardioembolism in patients with ischemic stroke. Cardiac CT is a promising alternative as a first-line screening method. We aimed to determine whether cardiac CT, acquired during the initial stroke imaging protocol, has a higher yield for detecting high-risk cardioaortic sources of embolism than transthoracic echocardiography (TTE).
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