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

Abstract

Abstract Background and Aims Etiological investigation of potential cardiac source of acute ischemic stroke is important for secondary prevention of recurrent and future embolisation. 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 in Mogadishu, Somali Turkish Training and Research Hospital. Methods The study was retrospective observational study conducted in the neurology department of teaching hospital in Mogadishu, Somalia. The study focused on the assessment of echocardiographic findings of patients with acute ischemic stroke admitted to the neurology ward. The data was retrieved from the electronic records of patients admitted to the neurology department due to acute ischemic stroke. All patients with acute ischemic stroke who had undergone transthoracic echocardiography from March 2019 to March 2022 were enrolled. Findings The mean age of patients was 62 ± 12. The majority of the patients in the study were 60 years of age or older 210(66.7%). The male subjects in the study population accounted for 178(56.5%), while females accounted for 137(43.5%). 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%). Over all cardiac pathology in this study was 54%. 47(15%) of the patients had low ejection fraction on transthoracic echocardiography. Male patients had slightly less left ventricular systolic dysfunction than did female patients. 100(32%) had LVDD while 113(36%) had LVH. Left ventricular hypertrophy was more frequent in hypertensive patients (46% of hypertensive patients). Left ventricular diastolic dysfunction (LVDD) was more common among diabetic patients (60% of diabetic patients). Patient with hypertension and diabetes had more echo abnormalities compared to others (P-value of 0.047 and 0.024 respectively). More echo abnormal findings were seen in patients who died during hospitalization than those who survived. (P = 0.008). Severe LV dysfunction was associated higher mortality (P < 0.001). Conclusion Most patients with stroke in this study had abnormal echocardiogram, however few have cardioembolic strokes. Abnormalities in echocardiography were more common in in patients who died during hospitalization than those who survived.