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Kardiologische Diagnostik nach zerebraler Ischämie

Konsensuspapier der Arbeitsgemeinschaft Herz und Hirn der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e.V. (DGK) und der Deutschen Schlaganfallgesellschaft e.V. (DSG)

Cardiac workup after cerebral ischemia

Consensus paper of the Working Group on Heart and Brain of the German Cardiac Society and German Stroke Society

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Literatur

  1. Diener HC, Putzki N et al (2008) Leitlinien der DGN 2008. In: Kommission „Leitlinien der Deutschen Gesellschaft für Neurologie“ (Hrsg) Leitlinien für Diagnostik und Therapie in der Neurologie

  2. The Europeen Stroke Organization (ESO) Executive Committe and the ESO Writing Committee (2008) Guidelines for managment of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis 25:457–507

    Google Scholar 

  3. Capes SE, Hunt D, Malmberg K et al (2001) Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke 32:2426–2432

    CAS  PubMed  Google Scholar 

  4. Alvarez-Sabin J, Molina CA, Montaner J et al (2003) Effects of admission hyperglycemia on stroke outcome in reperfused tissue plasminogen activator–treated patients. Stroke 34:1235–1241

    PubMed  Google Scholar 

  5. McCormick MT, Muir KW, Gray CS et al (2008) Management of hyperglycemia in acute stroke: how, when, and for whom? Stroke 39:2177–2185

    PubMed  Google Scholar 

  6. Fuentes B, Castillo J, San JB et al (2009) The prognostic value of capillary glucose levels in acute stroke: the GLycemia in Acute Stroke (GLIAS) Study. Stroke 40:562–568

    CAS  PubMed  Google Scholar 

  7. Ringleb PA et al (2009) Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008. The European Stroke Organization (ESO) Executive Committee and the ESO Writing Committee. http://www.eso-stroke.org/pdf/ESO%20Guidelines_update_Jan_2009.pdf

  8. Gray CS, Hildreth AJ, Sandercock PA et al (2007) Glucose-potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK Glucose Insulin in Stroke Trial (GIST-UK). Lancet Neurol 6:397–406

    CAS  PubMed  Google Scholar 

  9. Yong M, Kaste M (2008) Dynamic of hyperglycemia as a predictor of stroke outcome in the ECASS-II trial. Stroke 39:2749–2755

    PubMed  Google Scholar 

  10. Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) (2007) Guidelines on diabetes, pre-diabetes, and cardiovascular diseases. Eur Heart J [Suppl 9]:C3–C74

  11. Kerner W, Brückel J (2007) Definition, Klassifikation und Diagnostik. Diabetologie [Suppl 2]:147–149

  12. Prospective Studies Collaboration, Lewington S, Whitlock G, Clarke R et al (2007) Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet 370:1829–1839

    Google Scholar 

  13. Kurth T, Everett BM, Buring JE et al (2007) Lipid levels and the risk of ischemic stroke in women. Neurology 68:556–562

    CAS  PubMed  Google Scholar 

  14. Sanossian N, Tarlov NE (2008) HDL-C and LDL-C: their role in stroke pathogenesis and implications for treatment. Curr Treat Options Cardiovasc Med 10:195–206

    PubMed  Google Scholar 

  15. Bansal S, Buring JE, Rifai N et al (2007) Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA 298:309–316

    CAS  PubMed  Google Scholar 

  16. Freiberg JJ, Tybjaerg-Hansen A, Jensen JS et al (2008) Nonfasting triglycerides and risk of ischemic stroke in the general population. JAMA 300:2142–2152

    CAS  PubMed  Google Scholar 

  17. Bang OY, Saver JL, Liebeskind DS et al (2008) Association of serum lipid indices with large artery atherosclerotic stroke. Neurology 70:841–847

    CAS  PubMed  Google Scholar 

  18. Kamstrup PR, Tybjærg-Hansen A, Steffensen R et al (2009) Genetically elevated lipoprotein(a) and increased risk of myocardial infarction. JAMA 301:2331–2339

    CAS  PubMed  Google Scholar 

  19. Amarenco P, Labreuche J (2009) Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention. Lancet Neurol 8:453–463

    CAS  PubMed  Google Scholar 

  20. Heart Protection Study Collaborative Group (2002) MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomised placebocontrolled trial. Lancet 360:7–22

    Google Scholar 

  21. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators (2006) High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med 355:549–559

    Google Scholar 

  22. Adams HP, Zoppo G del, Alberts MJ et al (2007) Atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups. Stroke 38:1655–1711

    PubMed  Google Scholar 

  23. Sacco RL, Adams R, Albers G et al (2006) Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Circulation 113:409–449

    Google Scholar 

  24. Pezzini A, Del ZE, Magoni M et al (2003) Inherited thrombophilic disorders in young adults with ischemic stroke and patent foramen ovale. Stroke 34:28–33

    PubMed  Google Scholar 

  25. Botto N, Spadoni I, Giusti S et al (2007) Prothrombotic mutations as risk factors for cryptogenic ischemic cerebrovascular events in young subjects with patent foramen ovale. Stroke 38:2070–2073

    CAS  PubMed  Google Scholar 

  26. Buller HR, Agnelli G, Hull RD et al (2004) Antithrombotic therapy for venous thromboembolic disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126 [Suppl 3]:401–428

  27. Lim W, Crowther MA, Eikelboom JW (2006) Management of antiphospholipid antibody syndrome: a systematic review. JAMA 295:1050–1057

    CAS  PubMed  Google Scholar 

  28. Homocysteine Studies Collaboration (2002) Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA 288:2015–2022

    Google Scholar 

  29. Toole JF, Malinow MR, Chambless LE et al (2004) Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. JAMA 291:565–575

    CAS  PubMed  Google Scholar 

  30. Bonaa KH, Njolstad I, Ueland PM et al (2006) Homocysteine lowering and cardiovascular events after acute myocardial infarction. N Engl J Med 354:1578–1588

    CAS  PubMed  Google Scholar 

  31. Lonn E, Yusuf S, Arnold MJ et al (2006) Homocysteine lowering with folic acid and B vitamins in vascular disease. N Engl J Med 354:1567–1577

    CAS  PubMed  Google Scholar 

  32. Liman T, Endres M (2008) Elevated troponin and ECG alterations in acute ischemic stroke and subarachnoid hemorrhage. Nervenarzt 79:1386–1398

    CAS  PubMed  Google Scholar 

  33. Jensen JK, Kristensen SR, Bak S et al (2007) Frequency and significance of troponin T elevation in acute ischemic stroke. Am J Cardiol 99108–99112

  34. James P, Ellis CJ, Whitlock RM et al (2000) Relation between troponin T concentration and mortality in patients presenting with an acute stroke: observational study. BMJ 320:1502–1504

    CAS  PubMed  Google Scholar 

  35. Di AE, Fiorelli M, Toni D et al (2005) Prognostic significance of admission levels of troponin I in patients with acute ischaemic stroke. J Neurol Neurosurg Psychiatry 76:76–81

    Google Scholar 

  36. Rubattu S, Sciarretta S, Valenti V et al (2008) Natriuretic peptides: an update on bioactivity, potential therapeutic use, and implication in cardiovascular diseases. Am J Hypertens 21:733–741

    CAS  PubMed  Google Scholar 

  37. Kistorp C, Raymond I, Pedersen F et al (2005) N-terminal pro-brain natriuretic peptide, C-reactive protein, and urinary albumin levels as predictors of mortality and cardiovascular events in older adults. JAMA 293:1609–1616

    CAS  PubMed  Google Scholar 

  38. Di NM, Schwaninger M, Cappelli R et al (2005) Evaluation of C-reactive protein measurecument for assessing the risk and prognosis in ischemic stroke: a statement for health care professionals from the CRP Pooling Project members. Stroke 36:1316–1329

    Google Scholar 

  39. Elkind MS (2009) Inflammatory markers and stroke. Curr Cardiol Rep 11:12–20

    PubMed  Google Scholar 

  40. Ridker PM, Danielson E, Fonseca FA et al (2008) Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 359:2195–2207

    CAS  PubMed  Google Scholar 

  41. Ross R (1999) Atherosclerosis-an inflammatory disease. N Engl J Med 340:115–126

    CAS  PubMed  Google Scholar 

  42. Ridker PM, Buring JE, Rifai N et al (2007) Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA 297:611–619

    CAS  PubMed  Google Scholar 

  43. Ridker PM, Cannon CP, Morrow D et al (2005) C-reactive protein levels and outcomes after statin therapy. N Engl J Med 352:20–28

    CAS  PubMed  Google Scholar 

  44. Grau AJ, Weimar C, Buggle F et al (2001) Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank. Stroke 32:559–566

    Google Scholar 

  45. Dimant J, Grob D (1977) Electrocardiographic changes and myocardial damage in patients with acute cerebrovascular accidents. Stroke 8:448–455

    CAS  PubMed  Google Scholar 

  46. Oppenheimer SA (1994) Neurogenic cardiac effects of cerebrovascular disease. Curr Opin Neurol 7:20–24

    CAS  PubMed  Google Scholar 

  47. Oppenheimer SM, Hachinski VC (1992) The cardiac consequences of stroke. Neurol Clin 10:167–176

    CAS  PubMed  Google Scholar 

  48. Mikolich JR, Jacobs WC, Fletcher GF (1981) Cardiac arrhythmias in patients with acute cerebrovascular accidents. JAMA 246:1314–1317

    CAS  PubMed  Google Scholar 

  49. Norris JF, Froggatt GM, Hachinski VC (1978) Cardiac arrhythmias in acute stroke. Stroke 9:392–396

    CAS  PubMed  Google Scholar 

  50. Hohnloser SH, Pajitnev D, Pogue J et al (2007) Incidence of stroke in paroxysmal versus sustained atrial fibrillation in patients taking oral anticoagulation or combined antiplatelet therapy: an ACTIVE W Substudy. J Am Coll Cardiol 50:2156–2161

    CAS  PubMed  Google Scholar 

  51. Fuster V, Ryden LE, Cannom DS et al (2006) ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation). Eur Heart J 27:1979–2030

    PubMed  Google Scholar 

  52. Hart RG, Pearce LA, Aguilar MI (2007) Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 146:857–867

    PubMed  Google Scholar 

  53. Kirchhof P, Auricchio A, Bax J et al (2007) Outcome parameters for trials in atrial fibrillation: executive summary: Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork (AFNET) and the European Heart Rhythm Association (EHRA). Eur Heart J 28:2803–2817

    PubMed  Google Scholar 

  54. Fetsch T, Bauer P, Engberding D et al (2004) Prevention of atrial fibrillation after cardioversion: results of the PAFAC trial. Eur Heart J 25:1385–1394

    PubMed  Google Scholar 

  55. Page RL, Wilkinson WE, Clair WK et al (1994) Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation 89:224–227

    CAS  PubMed  Google Scholar 

  56. Brignole M, Vardas P, Hoffman E et al (2009) Indications for the use of diagnostic implantable and external ECG loop recorders. Europace 11:671–687

    PubMed  Google Scholar 

  57. Barthelemy JC, Feasson-Gerard S, Garnier P et al (2003) Automatic cardiac event recorders reveal paroxysmal atrial fibrillation after unexplained strokes or transient ischemic attacks. Ann Noninvasive Electrocardiol 8:194–199

    PubMed  Google Scholar 

  58. Hornig CR, Haberbosch W, Lammers C et al (1996) Specific cardiological evaluation after focal cerebral ischemia. Acta Neurol Scand 93:297–302

    Article  CAS  PubMed  Google Scholar 

  59. Jabaudon D, Sztajzel J, Sievert K et al (2004) Usefulness of ambulatory 7-day ECG monitoring for the detection of atrial fibrillation and flutter after acute stroke and transient ischemic attack. Stroke 35:1647–1651

    PubMed  Google Scholar 

  60. Liao J, Khalid Z, Scallan C et al (2007) Noninvasive cardiac monitoring for detecting paroxysmal atrial fibrillation or flutter after acute ischemic stroke: a systematic review. Stroke 38:2935–2944

    PubMed  Google Scholar 

  61. Rem JA, Hachinski VC, Boughner DR et al (1985) Value of cardiac monitoring and echocardiography in TIA and stroke patients. Stroke 16:950–956

    CAS  PubMed  Google Scholar 

  62. Schaer BA, Zellweger MJ, Cron TA et al (2004) Value of routine holter monitoring for the detection of paroxysmal atrial fibrillation in patients with cerebral ischemic events. Stroke 35:68–70

    Google Scholar 

  63. Schuchert A, Behrens G, Meinertz T (1999) Impact of long-term ECG recording on the detection of paroxysmal atrial fibrillation in patients after an acute ischemic stroke. Pacing Clin Electrophysiol 22:1082–1084

    CAS  PubMed  Google Scholar 

  64. Shafqat S, Kelly PJ, Furie KL (2004) Holter monitoring in the diagnosis of stroke mechanism. Intern Med J 34:305–309

    CAS  PubMed  Google Scholar 

  65. Tayal AH, Tian M, Kelly KM et al (2008) Atrial fibrillation detected by mobile cardiac outpatient telemetry in cryptogenic TIA or stroke. Neurology 71:1696–1701

    CAS  PubMed  Google Scholar 

  66. Tagawa M, Takeuchi S, Chinushi M et al (2007) Evaluating patients with acute ischemic stroke with special reference to newly developed atrial fibrillation in cerebral embolism. Pacing Clin Electrophysiol 30:1121–1128

    PubMed  Google Scholar 

  67. Mant J, Hobbs FD, Fletcher K et al (2007) Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA) a randomised controlled trial. Lancet 370:493–503

    CAS  PubMed  Google Scholar 

  68. Knecht S, Oelschlager C, Duning T et al (2008) Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. Eur Heart J 29:2125–2132

    Google Scholar 

  69. Miller VT, Pearce LA, Feinberg WM et al (1996) Differential effect of aspirin versus warfarin on clinical stroke types in patients with atrial fibrillation. Stroke Prevention in Atrial Fibrillation Investigators. Neurology 46:238–240

    CAS  PubMed  Google Scholar 

  70. Marini C, De Santis F, Sacco S et al (2005) Contribution of atrial fibrillation to incidence and outcome of ischemic stroke: results from a population-based study. Stroke 36:1115–1119

    PubMed  Google Scholar 

  71. Hoppe UC, Casares JM, Eiskjaer H et al (2006) Effect of cardiac resynchronization on the incidence of atrial fibrillation in patients with severe heart failure. Circulation 114:18–25

    PubMed  Google Scholar 

  72. Israel CW, Gronefeld G, Ehrlich JR et al (2004) Long-term risk of recurrent atrial fibrillation as documented by an implantable monitoring device: implications for optimal patient care. J Am Coll Cardiol 43:47–52

    PubMed  Google Scholar 

  73. Capucci A, Santini M, Padeletti L et al (2005) Monitored atrial fibrillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial fibrillation implanted with antitachycardia pacemakers. J Am Coll Cardiol 46:1913–1920

    PubMed  Google Scholar 

  74. Glotzer TV (2008) The TRENDS Study: Is there a critical value of daily atrial tachyarrhytmia burden from device diagnostics that raises stroke risk? ACC (Abstr)

  75. Glotzer TV, Hellkamp AS, Zimmerman J et al (2003) Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the Mode Selection Trial (MOST) Circulation 107:1614–1619

    Google Scholar 

  76. Petty GW, Brown RD Jr, Whisnant JP et al (1999) Ischemic stroke subtypes: a population-based study of incidence and risk factors. Stroke 30:2513–2516

    CAS  PubMed  Google Scholar 

  77. Amarenco P, Röther J, Michel P et al (2006) Aortic arch atheroma and the risk of stroke. Curr Atheroscler Rep 8:343–346

    PubMed  Google Scholar 

  78. Agmon Y, Khandheria BK, Gentile F et al (2002) Clinical and echocardiographic characteristics of patients with left atrial thrombus and sinus rhythm: experience in 20.643 consecutive transesophageal echocardiographic examinations. Circulation 105:27–31

    PubMed  Google Scholar 

  79. Busse O, Darius H (2002) Indikationen zur Echokardiographie beim ischämischen zerebralen Insult. Nervenarzt 73:792–795

    CAS  PubMed  Google Scholar 

  80. Flemming KD, Brown RD Jr, Petty GW et al (2004) Evaluation and management of transient ischemic attack and minor cerebral infarction. Mayo Clin Proc 79:1071–1086

    PubMed  Google Scholar 

  81. Handke M, Harloff A, Olschewski M et al (2007) Patent foramen ovale and cryptogenic stroke in older patients. N Engl J Med 357:2262–2268

    CAS  PubMed  Google Scholar 

  82. Overell JR, Bone I, Less KR (2000) Interatrial septal abnormalities and stroke. A meta-analysis of case-control studies. Neurology 55:1172–1179

    CAS  PubMed  Google Scholar 

  83. Meissner I, Whisnant JP, Khandheria BK et al (1999) Prevalence of potential risk factors for stroke assessed by transesophageal echocardiography and carotid ultrasonography: the SPARC study. Mayo Clin Proc 74:862–869

    CAS  PubMed  Google Scholar 

  84. Mas JL, Arquizan C, Lamy C et al (2001) Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. N Engl J Med 345:1740–1746

    CAS  PubMed  Google Scholar 

  85. Giardini A, Donti A, Formigari R et al (2004) Comparison of results of percutaneous closure of patent foramen ovale for paradoxical embolism in patients with versus without thrombophilia. Am J Cardiol 94:1012–1016

    PubMed  Google Scholar 

  86. Goel SS, Tuzcu EM, Shishehbor MH et al (2009) Morphology of the patent foramen ovale in asymptomatic versus symptomatic (stroke or transient ischemic attack) patients. Am J Cardiol 103:124–129

    PubMed  Google Scholar 

  87. Homma S, Sacco RL, Di Tullio MR et al (2002) Effect of medical treatment in stroke patients with patent foramen ovale. Circulation 105:2625–2631

    PubMed  Google Scholar 

  88. Messe S, Silverman I, Kizer J et al (2004) Practice parameter: recurrent stroke with patent foramen ovale and atrial septal aneurysm: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 62:1042–1050

    CAS  PubMed  Google Scholar 

  89. Slottow TL, Steinberg DH, Waksman R (2007) Overview of the 2007 Food and Drug Administration Circulatory System Devices Panel meeting on patent foramen ovale closure devices. Circulation 116:677–682

    PubMed  Google Scholar 

  90. Hung J, Landzberg MJ, Jenkins KJ et al (2000) Closure of patent foramen ovale for paradoxical emboli: intermediate-term risk of recurrent neurological events following transcatheter device placement. J Am Coll Cardiol 35:1311–1316

    CAS  PubMed  Google Scholar 

  91. Khairy P, O’Donnell CP, Landzberg MJ (2003) Transcatheter closure versus medical therapy of patent foramen ovale and presumed paradoxical thromboemboli: a systematic review. Ann Intern Med 139:753–760

    PubMed  Google Scholar 

  92. Braun MU, Fassbender D, Schoen SP et al (2002) Transcatheter closure of patent foramen ovale in patients with cerebral ischemia. J Am Coll Cardiol 39:2019–2025

    PubMed  Google Scholar 

  93. Windecker S, Wahl A, Chatterjee T et al (2000) Percutaneous closure of patent foramen ovale in patients with paradoxical embolism: long-term risk of recurrent thromboembolic events. Circulation 101:893–898

    CAS  PubMed  Google Scholar 

  94. Cifarelli A, Musto C, Parma A et al (2009) Long-term outcome of transcatheter patent foramen ovale closure in patients with paradoxical embolism. Int J Cardiol (Epub ahead of print)

  95. Rigatelli G, Aggio S, Cardaioli P et al (2009) Left atrial dysfunction in patients with patent foramen ovale and atrial septal aneurysm: an alternative concurrent mechanism for arterial embolism? JACC Cardiovasc Interv 2:655–662

    PubMed  Google Scholar 

  96. Berthet K, Lavergne T, Cohen A et al (2000) Significant association of atrial vulnerability with atrial septal abnormalities in young patients with ischemic stroke of unknown cause. Stroke 31(2):398–403

    CAS  PubMed  Google Scholar 

  97. Wöhrle J, Kochs M, Spiess et al (2009) Impact of percutaneous device implantation for closure of patent foramen ovale on valve insufficiencies. Circulation 119:3002–3008

    PubMed  Google Scholar 

  98. Chiarella F, Santoro E, Domenicucci S et al (1998) Predischarge two-dimensional echocardiographic evaluation of left ventricular thrombosis after acute myocardial infarction in the GISSI-3 study. Am J Cardiol 81:822–827

    CAS  PubMed  Google Scholar 

  99. Anzola G, Morandi E, Casilli F et al (2004) Does transcatheter closure of patent foramen ovale really „ shut the door?“ – A prospective study with transcranial doppler. Stroke 35:2140–2144

    CAS  PubMed  Google Scholar 

  100. Serena J, Marti-Fàbregas J, Santamarina E et al (2008) Recurrent stroke and massive right-to-left shunt: results from the prospective Spanish multicenter (CODICIA) study. Stroke 39:3131–3139

    PubMed  Google Scholar 

  101. Torti SR, Billinger M, Schwerzmann M et al (2004) Risk of decompression illness among 230 divers in relation to the presence and size of patent foramen ovale. Eur Heart J 25:2173–2174

    Google Scholar 

  102. Tunick PA, Nayar AC, Goodkin GM et al (2002) NYU Atheroma Group. Effect of treatment on the incidence of stroke and other emboli in 519 patients with severe thoracic aortic plaque. Am J Cardiol 90:1320–1325

    PubMed  Google Scholar 

  103. Cheitlin MD, Armstrong WF, Aurigemma GP et al (2003) ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). J Am Coll Cardiol 42:954–970

    PubMed  Google Scholar 

  104. Witt BJ, Gami AS, Ballman KV et al (2007) The incidence of ischemic stroke in chronic heart failure: a meta-analysis. J Card Fail 13:489–496

    PubMed  Google Scholar 

  105. Pullicino PM, Halperin JL, Thompson JLP (2000) Stroke in patients with heart failure and reduced left ventricular ejection fraction. Neurology 54:288–294

    CAS  PubMed  Google Scholar 

  106. Massie BM, Collins JF, Ammon SE et al (2009) WATCH Trial Investigators. Randomized trial of warfarin, aspirin, and clopidogrel in patients with chronic heart failure: the Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) trial. Circulation 119:1616–1624

    CAS  PubMed  Google Scholar 

  107. Krinsky G, Maya M, Rofsky N et al (1998) Gadolinium-enhanced 3D MRA of the aortic arch vessels in the detection of atherosclerotic cerebrovascular occlusive disease. J Comput Assist Tomogr 22:167–178

    CAS  PubMed  Google Scholar 

  108. Ferrari E, Vidal R, Chevallier T et al (1999) Atherosclerosis of the thoracic aorta and aortic debris as a marker of poor prognosis: Benefit of oral anticoagulants. J Am Coll Cardiol 33:1317–1322

    CAS  PubMed  Google Scholar 

  109. Ringelstein EB, Arnold M, Dittrich R et al (2008) Dissektionen hirnversorgender supraaortaler Arterien, in: Kommission „Leitlinien der Deutschen Gesellschaft für Neurologie“ (Hrsg) Leitlinien für Diagnostik und Therapie in der Neurologie 288–297

  110. Amarenco P, Cohen A, Tzourio C et al (1994) Atherosclerotic disease of the aortic arch and the risk of ischemic stroke. N Engl J Med 331:1474–1479

    CAS  PubMed  Google Scholar 

  111. Harloff A, Strecker C, Dudler P et al (2009) Retrograde embolism from the descending aorta: visualization by multidirectional 3D velocity mapping in cryptogenic stroke. Stroke 40:1505–1508

    PubMed  Google Scholar 

  112. Mohr JP, Thompson JL, Lazar RM et al (2001) Warfarin-Aspirin Recurrent Stroke Study Group (WARSS). A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. N Engl J Med 345:1444–1451

    CAS  PubMed  Google Scholar 

  113. Tunick PA, Nayar AC, Goodkin GM et al (2002) Effect of treatment on the incidence of stroke and other emboli in 519 patients with severe thoracic aortic plaque. Am J Cardiol 90:1320

    PubMed  Google Scholar 

  114. Cannegieter S, Rosendaal F, Wintzen A et al (1995) Optimal oral anticoagulant therapy in patients with mechanical heart valves. N Engl J Med 333:11–17

    CAS  PubMed  Google Scholar 

  115. Salem DN, Levine HJ, Pauker SG et al (1998) Antithrombotic therapy in valvular heart disease. Chest 114 [Suppl]:590–601

    Google Scholar 

  116. Bonow RO, Carabello BA, Chatterjee K et al (2008) Focused Update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. a report of the american college of cardiology/american heart association task force on practice guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease). Circulation 118:523–661

    Google Scholar 

  117. Gilon D, Bounanno FS, Joffe MM et al (1999) Lack of evidence of an association between mitral-valve prolapse and stroke in young patients. N Engl J Med 341:8–13

    CAS  PubMed  Google Scholar 

  118. Baddour LM, Wilson WR, Bayer AS et al (2005) Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation 111:394–434

    Google Scholar 

  119. Cartoni D, De Castro S, Valente G et al (2004) Identification of professional scuba divers with patent foramen ovale at risk for decompression illness. Am J Cardiol 94:270–273

    PubMed  Google Scholar 

  120. Weimar C, Holle DN, Benemann J (2009) German Stroke Study Collaboration. Current management and risk of recurrent stroke in cerebrovascular patients with right-to-left cardiac shunt. Cerebrovasc Dis 28:349–356

    CAS  PubMed  Google Scholar 

  121. Galiè N, Hoeper MM, Humbert M et al (2009) Guidelines for the diagnosis and treatment of pulmonary hypertension: The Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J [Epub ahead of print] PMID: 19713419

  122. Kapral MK, Silver FL (1999) Preventive health care, 1999 update: 2. Echocardiography for the detection of a cardiac source of embolus in patients with stroke. Canadian Task Force on Preventive Health Care. CMAJ 161:989–996

    CAS  PubMed  Google Scholar 

  123. Peterson GE, Brickner ME, Reimold SC (2003) Transesophageal echocardiography: Clinical indications and applications. Circulation 107:2398–2402

    PubMed  Google Scholar 

  124. Lerakis S, Nicholson WJ (2005) Part I. Use of echocardiography in the evaluation of patients with suspected cardioembolic stroke. Am J Med Sci 329:310–316

    PubMed  Google Scholar 

  125. Zabalgoitia M, Halperin JL, Pearce LA et al (1998) Transesophageal echocardiographic correlates of clinical risk of thromboembolism in nonvalvular atrial fibrillation. Stroke Prevention in Atrial Fibrillation III Investigators. J Am Coll Cardiol 31:1622–1626

    CAS  PubMed  Google Scholar 

  126. Hankey GJ, Jamrozik K, Broadhurst RJ et al (2000) Five-year survival after first-ever stroke and related prognostic factors in the Perth Community Stroke Study. Stroke 31:2080–2086

    CAS  PubMed  Google Scholar 

  127. O’Rourke RA, Brundage BH, Froelicher VF et al (2000) American College of Cardiology/American Heart Association Expert Consensus Document on Electron-Beam Computed Tomography for the Diagnosis and Prognosis of Coronary Artery Disease. Circulation 102:126–140

    Google Scholar 

  128. Michaelides AP, Psomadaki ZD, Dilaveris PE et al (1999) Improved detection of coronary artery disease by exercise electrocardiography with the use of right precordial leads. N Engl J Med 340:340–345

    CAS  PubMed  Google Scholar 

  129. Baer FM (2007) Stress-ECG is the first step to assess myocardial ischemia: when are additional diagnostic tests needed? Dtsch Med Wochenschr 132:2026–2030

    CAS  PubMed  Google Scholar 

  130. Evans A, Perez I, Yu G et al (2001) Should stroke subtype influence anticoagulation decisions to prevent recurrence in stroke patients with atrial fibrillation? Stroke 32:2828–2832

    CAS  PubMed  Google Scholar 

  131. Sacco RL, Adams R, Albers G et al (2006) Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Stroke 37:577–617

    PubMed  Google Scholar 

  132. Bethesda M (1993) National cholesterol education program. Second report of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel II). Nat Heart Lung Blood Inst, pp 93–3095

  133. Law M, Wald N, Rudnicka A (2003) Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ 326:1423

    CAS  PubMed  Google Scholar 

  134. Cholesterol Treatment Trialists (CTT) Collaborators (2008) Efficacy of cholesterol-lowering therapy in 18 686 people with diabetes in 14 randomised trials of statins: a meta-analysis Lancet 371:117–125

    Google Scholar 

  135. Patten, M, Maas R, Bauer P et al (2004) Suppression of paroxysmal atrial tachyarrhythmias-results of the SOPAT trial. Eur Heart J 25:1395–1404

    PubMed  Google Scholar 

  136. Botto G, Padeletti L, Santini M et al (2009) Presence and duration of atrial fibrillation detected by continuous monitoring: crucial implications for the risk of thromboembolic events. J Cardiovasc Electrophysiol 20:241–248

    PubMed  Google Scholar 

  137. Barkan D, Abu Fanne R, Elazari-Scheiman A et al (2007) Navel piercing as a cause for Streptococcus viridans endocarditis: case report, review of the literature and implications for antibiotic prophylaxis. Cardiology 108:159–160

    PubMed  Google Scholar 

  138. Bogousslavsky J, Regli F (1987) Ischemic stroke in adults younger than 30 years of age: cause and prognosis. Arch Neurol 44:4779–4782

    Google Scholar 

  139. De Bruijn SF, Agema WR, Lammers GJ et al (2006) Transesophageal echocardiography is superior to transthoracic echocardiography in management of patients of any age with transient ischemic attack or stroke. Stroke 37:2531–2534

    Google Scholar 

  140. Di Tulio MR, Homma S (2002) Mechanisms of cardioembolic stroke. Curr Cardiol Rep 4:141–148

    Google Scholar 

  141. Hardman SMC, Cowie MR (1999) Anticoagulation in heart disease. Br Med J 318:238–244

    CAS  Google Scholar 

  142. Meyer R (2001) Piercing: Gefährlicher Körperschmuck. Dtsch Ärztebl 98:A819–A820

    Google Scholar 

  143. Stroke Prevention in Atrial Fibrillation Study Group (1992) Predictors of thromboembolism in atrial fibrillation. Echocardiographic features of patients at risk. Ann Intern Med 116:6–12

    Google Scholar 

  144. Nationale Versorgungsleitlinie (NVL) Chronische KHK (2006) Träger: Bundesärztekammer, Kassenärztliche Bundesvereinigung, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften. Autoren: Donner-Banzhoff N, Held K, Laufs U et al (Hrsg: ÄZQ) http://www.versorgungsleitlinien.de/themen/khk/pdf/nvl_khk_lang.pdf

  145. Bhatt DL, Steg PG, Ohman EM et al (2006) REACH Registry Investigators. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA 295(2):180–189

    CAS  PubMed  Google Scholar 

  146. Smith SC Jr, Allen J, Blair SN et al (2006) AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation 113:2363–2372

    PubMed  Google Scholar 

  147. Gohlke H, Albus C, Bönner G et al (2007) Leitlinie Risikoadjustierte Prävention von Herz- und Kreislauferkrankungen. Deutsche Gesellschaft Für Kardiologie − Herz- und Kreislaufforschung e.V

  148. Röther J, Alberts MJ, Touzé E et al (2008) Steg on behalf of the REACH Registry Investigators Risk Factor Profile and Management of Cerebrovascular Patients in the REACH Registry. Cerebrovasc Dis 25:366–374

    PubMed  Google Scholar 

  149. Graham I, Atar D, Borch-Johnsen K et al (2007) European guidelines on cardiovascular disease prevention in clinical practice. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice. Eur J Cardiovasc Prev Rehabil 14 [Suppl 2]:1–113

  150. Sivenius J, Cunha L, Diener HC et al (1999) Antiplatelet treatment does not reduce the severity of subsequent stroke. European Stroke Prevention Study 2 Working Group. Neurology 53:825–829

    CAS  PubMed  Google Scholar 

  151. Yilmaz A, Sechtem U (2008) Cardiac imaging in suspected coronary artery disease. Dtsch Med Wochenschr 133:644–649

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Innere Medizin III, Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, 66421, Homburg, Deutschland

    U. Laufs & M. Böhm

  2. Klinik III für Innere Medizin, Herzzentrum der Universität zu Köln, Köln, Deutschland

    U.C. Hoppe & S. Rosenkranz

  3. Medizinische Klinik und Poliklinik C, Universiätsklinkum Münster, Münster, Deutschland

    P. Kirchhof

  4. Neurologische Klinik, Universitätsklinikum Essen, Essen, Deutschland

    H.-C. Diener

  5. Klinik für Neurologie, Campus Mitte, Universitätsklinikum Charitè, Berlin, Deutschland

    M. Endres

  6. Klinik für Neurologie, Kreisklinikum Siegen, Siegen, Deutschland

    M. Grond

  7. Neurologische Klinik, Universitätsklinik Heidelberg, Heidelberg, Deutschland

    W. Hacke

  8. Klinik und Poliklinik für Kardiologie/ Angiologie, Universitäres Herzzentrum Hamburg, Hamburg, Deutschland

    T. Meinertz

  9. Klinik und Poliklinik für Neurolgie, Universitäsklinikum Münster, Münster, Deutschland

    E.B. Ringelstein

  10. Neurologische Klinik, Johannes-Wesling-Klinikum, Minden, Deutschland

    J. Röther

  11. Neurologische Klinik, Ludwig-Maximilians-Universität, Klinikum Großhadern, München, Deutschland

    M. Dichgans

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  1. U. Laufs
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Correspondence to U. Laufs.

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Laufs, U., Hoppe, U., Rosenkranz, S. et al. Kardiologische Diagnostik nach zerebraler Ischämie. Nervenarzt 81, 444–462 (2010). https://doi.org/10.1007/s00115-009-2901-3

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