Searching for Explanations for Cryptogenic Stroke in the Young : Revealing the Etiology, Triggers, and Outcome (SECRETO): echocardiography performance protocol

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Saeed , S , Gerdts , E , Waje-Andreassen , U , Sinisalo , J & Putaala , J 2019 , ' Searching for Explanations for Cryptogenic Stroke in the Young : Revealing the Etiology, Triggers, and Outcome (SECRETO): echocardiography performance protocol ' , Echo research and practice , vol. 6 , no. 3 , pp. 53-61 . https://doi.org/10.1530/ERP-19-0025

Title: Searching for Explanations for Cryptogenic Stroke in the Young : Revealing the Etiology, Triggers, and Outcome (SECRETO): echocardiography performance protocol
Author: Saeed, Sahrai; Gerdts, Eva; Waje-Andreassen, Ulrike; Sinisalo, Juha; Putaala, Jukka
Contributor: University of Helsinki, HUS Heart and Lung Center
University of Helsinki, HUS Neurocenter
Date: 2019-09
Language: eng
Number of pages: 9
Belongs to series: Echo research and practice
ISSN: 2055-0464
URI: http://hdl.handle.net/10138/305439
Abstract: Background: The incidence of ischemic stroke in young patients is increasing and associated with unfavorable prognosis due to high risk of recurrent cardiovascular events. In many young patients the cause of stroke remains unknown, referred to as cryptogenic stroke. Neuroimaging frequently suggests a proximal source of embolism in these strokes. We developed a comprehensive step-by-step echocardiography protocol for a prospective study with centralized reading to characterize preclinical cardiac changes associated with cryptogenic stroke. Methods and study design: SECRETO (Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome; NCT01934725) is an ongoing multicenter case-control study enrolling patients (target n = 600) aged 18-49 years hospitalized due to first-ever ischemic stroke of undetermined etiology and age- and sex-matched controls (target n = 600). A comprehensive assessment of cardiovascular risk factors and extensive cardiac imaging with transthoracic and transesophageal echocardiography, electrocardiography and neurovascular imaging is performed. Transthoracic and transesophageal echocardiograms will be centrally read, following an extensive protocol particularly emphasizing the characteristics of left atrium, left atrial appendage and interatrial septum. Conclusions: A detailed assessment of both conventional and unconventional vascular risk factors and cardiac imaging with transthoracic and transesophageal echocardiography are implemented in SECRETO, aiming to establish indirect and direct risk factors and causes for cryptogenic stroke and novel pathophysiological brain-heart pathways. This may ultimately enable more personalized therapeutic options for these patients.
Subject: transthoracic echocardiography
transesophageal echocardiography
stroke
cardiac sources of embolism
patent foramen ovale
risk factors
PATENT FORAMEN OVALE
TRANSIENT ISCHEMIC ATTACK
AMERICAN SOCIETY
RISK-FACTORS
ADULTS
RECOMMENDATIONS
GUIDELINES
CLOSURE
3121 Internal medicine
3124 Neurology and psychiatry
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