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Therefore, we aimed to determine in these patients the prevalence of TTE-detected major cardiac sources of embolism (CSE), which are abnormalities leading to therapeutic changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Methods<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Six Dutch hospitals conducted a\u00a0prospective observational study that enrolled patients with ischaemic stroke or transient ischaemic attack of undetermined cause. Patients underwent TTE after comprehensive diagnostic evaluation on stroke units, including blood chemistry, 12-lead electrocardiogram (ECG), \u2265\u202f24\u202fh continuous ECG monitoring, brain imaging and cervical artery imaging. Primary outcome measure was the proportion of patients with TTE-detected major CSE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Results<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>From March 2018 to October 2020, 1084 patients, aged 66.6\u202f\u00b1\u200912.5 years, were enrolled; 456 (42.1%) patients were female and 869 (80.2%) had ischaemic stroke. TTE detected major CSE in only 11\u00a0(1.0%) patients. Ten (90.9%) of these patients also had major ECG abnormalities (previous infarction, major repolarisation abnormalities, or previously unknown left bundle branch block) that would have warranted TTE assessment regardless of stroke evaluation. Such ECG abnormalities were present in 11.1% of the total study population. A\u00a0single patient (0.1%) showed a\u00a0major CSE despite having no ECG abnormality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Conclusions<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>This multicentre cross-sectional study in patients who\u2014after workup on contemporary stroke units\u2014were diagnosed with ischaemic stroke or transient ischaemic attack of undetermined cause found TTE-detected major CSE in only 1% of all patients. Most of these patients also had major ECG abnormalities. These findings question the value of routine TTE assessment in this clinical setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12471-023-01819-7","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T08:01:46Z","timestamp":1698048106000},"page":"91-98","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Routine transthoracic echocardiography in ischaemic stroke or transient ischaemic attack of undetermined cause: a\u00a0prospective multicentre study"],"prefix":"10.1007","volume":"32","author":[{"given":"Gerlinde","family":"van der Maten","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs F. 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B.J.\u00a0Bouma reports that he is a\u00a0member of the Editorial Board of the <i>Netherlands Heart Journal<\/i>. G.\u00a0van der Maten, M.F.L.\u00a0Meijs, J.R.\u00a0Timmer, P.J.A.M.\u00a0Brouwers, J.M.\u00a0Coutinho, H.\u00a0Kerkhoff, A.M.\u00a0Helming, J.H.\u00a0van Tuijl, N.A.\u00a0van der Meer, R.\u00a0Saxena, C.\u00a0Ebink, J.\u00a0van der Palen and H.M.\u00a0den Hertog declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}