Racial differences in the prevalence of cardiac sources of embolism in subjects with unexplained stroke or transient ischemic attack evaluated by transesophageal echocardiography

Jorge Kizer, Frank E. Silvestry, Stephen E. Kimmel, Scott E. Kasner, Susan E. Wiegers, Michael B. Erwin, Stephanie A. Schwalm, Mohan N. Viswanathan, John R. Pollard, Martin G. Keane, Martin G. St. John Sutton

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Little is known about the distribution of cardiac sources of embolism among African-Americans with cryptogenic cerebrovascular events. We compared the prevalence of potential cardiac sources of embolism between black and white patients referred to our laboratory for transesophageal echocardiographic (TEE) evaluation of unexplained stroke or transient ischemic attack. Records were reviewed to exclude subjects with high-risk cardiac or vascular disorders likely to explain the index event. Of 297 patients satisfying the inclusion criteria, 196 were white and 87 black. Potential cardioembolic sources were significantly less common in blacks than in whites (adjusted odds ratio [OR], 0.44; 95% confidence interval [CI] 0.26 to 0.75), and related largely to the difference in prevalence of interatrial communication (OR 0.40; 95% CI 0.21 to 0.74). In contrast, African-Americans had a higher prevalence of left ventricular (LV) hypertrophy (OR 3.50; 95% CI 1.97 to 6.22), and particularly, moderate or severe hypertrophy (OR 4.03; 95% CI 1.88 to 9.65) compared with whites. In conclusion, in African-Americans with unexplained cerebrovascular events, the yield of TEE for potential cardioembolic sources, and especially interatrial communication, is lower than in their white counterparts. African-Americans exhibit a substantially higher prevalence of LV hypertrophy, which may be a marker for a higher burden of subclinical cerebrovascular disease involved in the pathogenesis of cryptogenic cerebral ischemia in this population.

Original languageEnglish (US)
Pages (from-to)395-400
Number of pages6
JournalAmerican Journal of Cardiology
Volume90
Issue number4
DOIs
StatePublished - Aug 15 2002
Externally publishedYes

Fingerprint

Transient Ischemic Attack
Transesophageal Echocardiography
Embolism
African Americans
Stroke
Odds Ratio
Confidence Intervals
Left Ventricular Hypertrophy
Communication
Cerebrovascular Disorders
Brain Ischemia
Hypertrophy
Blood Vessels
Population
hydroquinone

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Racial differences in the prevalence of cardiac sources of embolism in subjects with unexplained stroke or transient ischemic attack evaluated by transesophageal echocardiography. / Kizer, Jorge; Silvestry, Frank E.; Kimmel, Stephen E.; Kasner, Scott E.; Wiegers, Susan E.; Erwin, Michael B.; Schwalm, Stephanie A.; Viswanathan, Mohan N.; Pollard, John R.; Keane, Martin G.; St. John Sutton, Martin G.

In: American Journal of Cardiology, Vol. 90, No. 4, 15.08.2002, p. 395-400.

Research output: Contribution to journalArticle

Kizer, J, Silvestry, FE, Kimmel, SE, Kasner, SE, Wiegers, SE, Erwin, MB, Schwalm, SA, Viswanathan, MN, Pollard, JR, Keane, MG & St. John Sutton, MG 2002, 'Racial differences in the prevalence of cardiac sources of embolism in subjects with unexplained stroke or transient ischemic attack evaluated by transesophageal echocardiography', American Journal of Cardiology, vol. 90, no. 4, pp. 395-400. https://doi.org/10.1016/S0002-9149(02)02496-7
Kizer, Jorge ; Silvestry, Frank E. ; Kimmel, Stephen E. ; Kasner, Scott E. ; Wiegers, Susan E. ; Erwin, Michael B. ; Schwalm, Stephanie A. ; Viswanathan, Mohan N. ; Pollard, John R. ; Keane, Martin G. ; St. John Sutton, Martin G. / Racial differences in the prevalence of cardiac sources of embolism in subjects with unexplained stroke or transient ischemic attack evaluated by transesophageal echocardiography. In: American Journal of Cardiology. 2002 ; Vol. 90, No. 4. pp. 395-400.
@article{62e2414cfcf342828fd625aed8c392f0,
title = "Racial differences in the prevalence of cardiac sources of embolism in subjects with unexplained stroke or transient ischemic attack evaluated by transesophageal echocardiography",
abstract = "Little is known about the distribution of cardiac sources of embolism among African-Americans with cryptogenic cerebrovascular events. We compared the prevalence of potential cardiac sources of embolism between black and white patients referred to our laboratory for transesophageal echocardiographic (TEE) evaluation of unexplained stroke or transient ischemic attack. Records were reviewed to exclude subjects with high-risk cardiac or vascular disorders likely to explain the index event. Of 297 patients satisfying the inclusion criteria, 196 were white and 87 black. Potential cardioembolic sources were significantly less common in blacks than in whites (adjusted odds ratio [OR], 0.44; 95{\%} confidence interval [CI] 0.26 to 0.75), and related largely to the difference in prevalence of interatrial communication (OR 0.40; 95{\%} CI 0.21 to 0.74). In contrast, African-Americans had a higher prevalence of left ventricular (LV) hypertrophy (OR 3.50; 95{\%} CI 1.97 to 6.22), and particularly, moderate or severe hypertrophy (OR 4.03; 95{\%} CI 1.88 to 9.65) compared with whites. In conclusion, in African-Americans with unexplained cerebrovascular events, the yield of TEE for potential cardioembolic sources, and especially interatrial communication, is lower than in their white counterparts. African-Americans exhibit a substantially higher prevalence of LV hypertrophy, which may be a marker for a higher burden of subclinical cerebrovascular disease involved in the pathogenesis of cryptogenic cerebral ischemia in this population.",
author = "Jorge Kizer and Silvestry, {Frank E.} and Kimmel, {Stephen E.} and Kasner, {Scott E.} and Wiegers, {Susan E.} and Erwin, {Michael B.} and Schwalm, {Stephanie A.} and Viswanathan, {Mohan N.} and Pollard, {John R.} and Keane, {Martin G.} and {St. John Sutton}, {Martin G.}",
year = "2002",
month = "8",
day = "15",
doi = "10.1016/S0002-9149(02)02496-7",
language = "English (US)",
volume = "90",
pages = "395--400",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Racial differences in the prevalence of cardiac sources of embolism in subjects with unexplained stroke or transient ischemic attack evaluated by transesophageal echocardiography

AU - Kizer, Jorge

AU - Silvestry, Frank E.

AU - Kimmel, Stephen E.

AU - Kasner, Scott E.

AU - Wiegers, Susan E.

AU - Erwin, Michael B.

AU - Schwalm, Stephanie A.

AU - Viswanathan, Mohan N.

AU - Pollard, John R.

AU - Keane, Martin G.

AU - St. John Sutton, Martin G.

PY - 2002/8/15

Y1 - 2002/8/15

N2 - Little is known about the distribution of cardiac sources of embolism among African-Americans with cryptogenic cerebrovascular events. We compared the prevalence of potential cardiac sources of embolism between black and white patients referred to our laboratory for transesophageal echocardiographic (TEE) evaluation of unexplained stroke or transient ischemic attack. Records were reviewed to exclude subjects with high-risk cardiac or vascular disorders likely to explain the index event. Of 297 patients satisfying the inclusion criteria, 196 were white and 87 black. Potential cardioembolic sources were significantly less common in blacks than in whites (adjusted odds ratio [OR], 0.44; 95% confidence interval [CI] 0.26 to 0.75), and related largely to the difference in prevalence of interatrial communication (OR 0.40; 95% CI 0.21 to 0.74). In contrast, African-Americans had a higher prevalence of left ventricular (LV) hypertrophy (OR 3.50; 95% CI 1.97 to 6.22), and particularly, moderate or severe hypertrophy (OR 4.03; 95% CI 1.88 to 9.65) compared with whites. In conclusion, in African-Americans with unexplained cerebrovascular events, the yield of TEE for potential cardioembolic sources, and especially interatrial communication, is lower than in their white counterparts. African-Americans exhibit a substantially higher prevalence of LV hypertrophy, which may be a marker for a higher burden of subclinical cerebrovascular disease involved in the pathogenesis of cryptogenic cerebral ischemia in this population.

AB - Little is known about the distribution of cardiac sources of embolism among African-Americans with cryptogenic cerebrovascular events. We compared the prevalence of potential cardiac sources of embolism between black and white patients referred to our laboratory for transesophageal echocardiographic (TEE) evaluation of unexplained stroke or transient ischemic attack. Records were reviewed to exclude subjects with high-risk cardiac or vascular disorders likely to explain the index event. Of 297 patients satisfying the inclusion criteria, 196 were white and 87 black. Potential cardioembolic sources were significantly less common in blacks than in whites (adjusted odds ratio [OR], 0.44; 95% confidence interval [CI] 0.26 to 0.75), and related largely to the difference in prevalence of interatrial communication (OR 0.40; 95% CI 0.21 to 0.74). In contrast, African-Americans had a higher prevalence of left ventricular (LV) hypertrophy (OR 3.50; 95% CI 1.97 to 6.22), and particularly, moderate or severe hypertrophy (OR 4.03; 95% CI 1.88 to 9.65) compared with whites. In conclusion, in African-Americans with unexplained cerebrovascular events, the yield of TEE for potential cardioembolic sources, and especially interatrial communication, is lower than in their white counterparts. African-Americans exhibit a substantially higher prevalence of LV hypertrophy, which may be a marker for a higher burden of subclinical cerebrovascular disease involved in the pathogenesis of cryptogenic cerebral ischemia in this population.

UR - http://www.scopus.com/inward/record.url?scp=0037102169&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037102169&partnerID=8YFLogxK

U2 - 10.1016/S0002-9149(02)02496-7

DO - 10.1016/S0002-9149(02)02496-7

M3 - Article

C2 - 12161229

AN - SCOPUS:0037102169

VL - 90

SP - 395

EP - 400

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 4

ER -