Analysis of Echocardiographic Findings of Patients with Acute Ischemic Stroke Admitted to a Tertiary Care Hospital in Mogadishu, Somalia

Abstract

Mohamed Sheikh Hassan,1 Mohamud Mire Waberi,2 Nor Osman Sidow,1 Mohamed Omar Hassan,2 Hakan Akyüz,2 Ishak Ahmed Abdi,2 Ahmed Muhammad Bashir,3 Said Abdirahman Ahmed2 1Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia; 2Department of Cardiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia; 3Department of Internal Medicine, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Mohamed Sheikh Hassan, Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia, Email [email protected] and Aims: The etiological investigation of the potential cardiac source of acute ischemic stroke is important for the secondary prevention of recurrent and future embolization. Transthoracic echocardiography is one of the most useful investigations for the assessment of the potential cardiac etiology of ischemic stroke. Our aim is to evaluate echocardiographic findings in patients with acute ischemic stroke admitted to a tertiary care hospital in Mogadishu, Somalia.Methods: This was a retrospective observational study conducted in the neurology department of a tertiary care hospital in Mogadishu, Somalia. We enrolled 315 patients with acute ischemic stroke admitted to the hospital who had undergone transthoracic echocardiography between March 2019 and March 2022. We analyzed transthoracic echocardiography findings, ischemic stroke subtypes, and their associated comorbidities. We also compared the demographic data, comorbidity, and survival status of patients with abnormal echo findings to those with normal echo findings.Findings: The mean age of patients was 62± 12 years. Co-morbidities were present in about 251 (80%) of the subjects, hypertension was the most common comorbidity 99 (31.4%), followed by diabetes 72 (23%), and hyperlipidemia 37 (11.7%). Overall cardiac pathology in this study was 170 (54%). Forty-seven (15%) of the patients had low ejection fraction on transthoracic echocardiography. Male patients had slightly less left ventricular systolic dysfunction than female patients. 100 (32%) had left ventricular diastolic dysfunction (LVDD), while 113 (36%) had left ventricular hypertrophy (LVH). Patients with hypertension and diabetes had more echo abnormalities compared to others (P-values of 0.047 and 0.024, respectively). More abnormal echo findings were seen in patients who died during hospitalization than in those who survived (P = 0.008). Severe left ventricular systolic dysfunction was associated with higher mortality (P < 0.001).Conclusion: Most patients with stroke in this study had abnormal echocardiograms; however, only a few had cardioembolic strokes. Abnormalities in echocardiography were more common in patients who died during hospitalization than in those who survived.Keywords: acute ischemic stroke, cardiac dysfunction, echocardiography

Keywords

• acute ischemic stroke
• cardiac dysfunction
• echocardiography