Other Clinical Trial - Embolic Stroke of Undetermined Source, Continuous

Status Recruiting

Clinical Trial Summary

Transthoracic echocardiography (TTE) is recommended in patients with ischemic stroke when cardiac etiology is suspected to help plan secondary stroke management. However, discrepancy for specific clinical recommendation exists between cardiologists and neurologists, and data evaluating usefulness of TTE in unselected patients with cryptogenic strokes (CS) and embolic strokes of undetermined source (ESUS) are lacking. The investigators sought to evaluate the value of routinely performed echocardiography in consecutive CS/ESUS patients. The investigators will perform TTE as recommended by guidelines including agitated saline contrast and speckle-tracking to investigate potential implications for secondary stroke management. In addition, the researchers aim to evaluate the effectiveness of long-term continuous electrocardiogram (cECG) monitorering with newer Holter monitors to detect cardiac arrhythmia in patients with CS/ESUS. In this prospective study, the investigators aim to evaluate 500 consecutive patients, regardless of age, in sinus rhythm with acute IS and potential cardioembolic stroke (CES) or cryptogenic stroke (CS/ESUS) according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Strokes are determined by magnetic resonance imaging. The researchers will perform TTE as recommended by guidelines including agitated saline contrast and speckle-tracking to investigate potential implications for secondary stroke management. The investigators aim to explore underlying heart conditions and comorbidities among CES and ESUS patients. Data will include left atrium morphology, atrial septal aneurysm, valvular disease, mural thrombus and patent foramen ovale (PFO). Focus will be analysis of data on older patients, as some studies indicate that in ESUS patients >60 years of age, there is a higher prevalence of PFO in patients with low atherosclerosis and cardioembolic risk. This project can potentially guide cardiologists and neurologists, on common grounds, for stroke management of potential cardioembolic origin. Implications of referring all-comers with stroke of potential cardioembolic origin to echocardiography will be illustrated.

Clinical Trial Description

n/a

Study Design

Related Conditions & MeSH terms

Embolic Stroke of Undetermined Source
Stroke

Clinical Trial Details

NCT number	NCT04808258
Study type	Observational
Source	Herlev and Gentofte Hospital
Contact	Morten Kjøbek Lamberts, MD, PhD
Phone	+4522434186
Email	morten.kjoebek.lamberts@regionh.dk
Status	Recruiting
Phase
Start date	November 27, 2020
Completion date	March 27, 2022

View Details

See also
Status	Clinical Trial	Phase
Completed	`NCT04455529` - Current Situation of Natural History, Diagnosis and Treatment in Inpatients With Embolism Stroke of Unknown Cause (ESUS)
Completed	`NCT04604015` - RoBotic TCD Ultrasound BubbLe Study Compared to Transthoracic Echocardiography for Detection of Right to Left Shunt	N/A
Completed	`NCT03107637` - Transesophageal Echocardiography in Embolic Stroke of Undetermined Source
Completed	`NCT03712865` - Thirty Day Heart Monitoring for Detection of Atrial Fibrillation Among Cryptogenic Stroke Patients
Completed	`NCT03377465` - Biomarkers, Hemodynamic and Echocardiographic Predictors of Ischemic Strokes and Their Influence on the Course and Prognosis	N/A
Recruiting	`NCT05431972` - Cardea SOLOTM for Paroxysmal Atrial Fibrillation Diagnosis in ESUS Patients With Left Atrial Enlargement	N/A
Active, not recruiting	`NCT03329365` - Paroxysmal Nocturnal Hemoglobinuria in ESUS & ETUS
Recruiting	`NCT05089435` - An Open-label Study of EZYPRO® in Atrial Fibrillation Detection on ESUS Patients	Phase 4
Recruiting	`NCT04717843` - Identification of New Markers of Atrial Myopathy in Patients With Embolic Stroke of Undetermined Source (ESUS) From MRI 4D Data	N/A
Enrolling by invitation	`NCT02766205` - Prediction of AF in ESUS
Recruiting	`NCT05238610` - Prospective Registry of Elderly ESUS With PFO
Recruiting	`NCT04898361` - PFO Occlusion and Atrial Fibrillation	N/A
Recruiting	`NCT06100718` - Discovery of New Cancer in the 1-year Follow-up After Ischemic Stroke in Patients at Risk: The INVISIBLE-1 Study
Recruiting	`NCT05044208` - Echocardiographic Predictors of Atrial Fibrillation
Recruiting	`NCT03820375` - Registry Study for the Observation of Patients With ESUS/Cryptogenic Stroke
Completed	`NCT03609437` - Impaired Endothelial Integrity in Patients With Embolic Stroke of Undetermined Source (ESUS)
Completed	`NCT03185520` - Young ESUS Patient Registry
Completed	`NCT02427126` - Apixaban for Treatment of Embolic Stroke of Undetermined Source	Phase 3

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

Embolic Stroke of Undetermined Source, Continuous Electrocardiography and Transthoracic ECHOcardiography in Hospitalized Patients With Ischemic Stroke — ESECHO

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms