Publications by authors named "C F P Beemsterboer"

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.

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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.
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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.

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  • 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.
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  • 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.
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