RT Journal Article SR Electronic T1 Echocardiographic wall motion abnormalities in patients with stroke may warrant cardiac evaluation JF Journal of Neurology, Neurosurgery & Psychiatry JO J Neurol Neurosurg Psychiatry FD BMJ Publishing Group Ltd SP 792 OP 795 DO 10.1136/jnnp-2018-320219 VO 90 IS 7 A1 Yaghi, Shadi A1 Chang, Andrew D A1 Ricci, Brittany A A1 MacGrory, Brian A1 Cutting, Shawna A1 Burton, Tina A1 Dakay, Katarina A1 McTaggart, Ryan A1 Jayaraman, Mahesh V A1 Merkler, Alexander E A1 Reznik, Michael A1 Lerario, Michael A1 Gupta, Ajay A1 Mehanna, Emile A1 Song, Christopher A1 Seiffge, David J A1 De Marchis, Gian Marco A1 Paciaroni, Maurizio A1 Kamel, Hooman A1 Elkind, Mitchell S V A1 Furie, Karen L YR 2019 UL http://jnnp.bmj.com/content/90/7/792.abstract AB Background The aetiology of wall motion abnormalities (WMA) in patients with ischaemic stroke is unclear. We hypothesised that WMAs on transthoracic echocardiography (TTE) in the setting of ischaemic stroke mostly reflect pre-existing coronary heart disease rather than simply an isolated neurocardiogenic phenomenon.Methods Data were retrospectively abstracted from a prospective ischaemic stroke database over 18 months and included patients with ischaemic stroke who underwent a TTE. Coronary artery disease was defined as history of myocardial infarction (MI), coronary intervention or ECG evidence of prior MI. The presence (vs absence) of WMA was abstracted. Multivariable logistic regression was used to determine the association between coronary artery disease and WMA in models adjusting for potential confounders.Results We identified 1044 patients who met inclusion criteria; 139 (13.3%, 95% CI 11.2% to 15.4%) had evidence of WMA of whom only 23 (16.6%, 95% CI 10.4% to 22.8%) had no history of heart disease or ECG evidence of prior MI. Among these 23 patients, 12 had a follow-up TTE after the stroke and WMA persisted in 92.7% (11/12) of patients. In fully adjusted models, factors associated with WMA were older age (OR per year increase 1.03, 95% 1.01 to 1.05, p=0.009), congestive heart failure (OR 4.44, 95% CI 2.39 to 8.33, p<0.001), history of coronary heart disease or ECG evidence prior MI (OR 27.03, 95% CI 14.93 to 50.0, p<0.001) and elevated serum troponin levels (OR 2.00, 95% CI 1.06 to 3.75, p=0.031).Conclusion In patients with ischaemic stroke, WMA on TTE may reflect underlying cardiac disease and further cardiac evaluation may be considered.