{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T13:32:59Z","timestamp":1790429579185,"version":"4.1.0"},"reference-count":12,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and purpose\u2014current guidelines recommend the use of transesophageal echocardiography (TEE) in relation to cardio-embolic sources of stroke. Methods\u2014by using an hospital-based cohort, we retrospectively analyzed consecutive patients with acute ischemic stroke (AIS), acute hemorrhagic stroke (AHS) and transient ischemic attack (TIA) who were admitted in Strasbourg Stroke Center, France between November 2017 to December 2018. TEE reports were screened for detection of potential cardiac sources of embolism and the subsequent change in medical management. We performed univariate and multivariate analyses to identify predictors of relevant TEE findings. Results-out of the 990 patients admitted with confirmed stroke, 432 patients (42.6%) underwent TEE. Patients with TEE were younger (62.8 \u00b1 14.8 vs. 73.8, p &lt; 0.001), presented less comorbidities and lower stroke severity assessed by lower NIHSS (2 IQR (0\u20134) vs. 3 IQR (0\u201310), p &lt; 0.01) and Modified Rankin Scale (1 IQR (0\u20131) vs. 1 (0\u20133), p &lt; 0.01). A total of 227 examinations (52.5%) demonstrated abnormal findings considered as potential cardiac sources of embolism and 31 examinations (7.1%) were followed by subsequent change in medical management. Age (HR: 0.948, 95% CI 0.923 to 0.974; p &lt; 0.001), previous AIS (HR: 3.542, 95% CI 1.290 to 9.722; p = 0.01), previous TIA (HR: 7.830, CI 95% 2214 to 27,689; p = 0.001) and superficial middle cerebral artery territory infarction (HR: 2.774, CI 95% 1.168\u20136.589; p = 0.021) were strong independent predictors with change in medical management following TEE. Conclusions\u2014additional TEE changed the medical course of stroke patients in 7.1% in a French high-volume stroke unit.<\/jats:p>","DOI":"10.3390\/jcm10040805","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T21:35:42Z","timestamp":1613597742000},"page":"805","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effect of Transoesophageal Echocardiography on Treatment Change in a High-Volume Stroke Unit"],"prefix":"10.3390","volume":"10","author":[{"given":"Camille","family":"Siegel","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7034-1466","authenticated-orcid":false,"given":"Benjamin","family":"Marchandot","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3722-2921","authenticated-orcid":false,"given":"Kensuke","family":"Matsushita","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"},{"name":"INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-4220","authenticated-orcid":false,"given":"Antonin","family":"Trimaille","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina","family":"Mirea","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilou","family":"Peillex","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Sauer","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile","family":"How-Choong","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floriane","family":"Zeyons","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6071-9496","authenticated-orcid":false,"given":"Olivier","family":"Rouyer","sequence":"additional","affiliation":[{"name":"Neurology Department, Hautepierre Hospital, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Trinh","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Petit-Eisenmann","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Jesel","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"},{"name":"INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8021-2737","authenticated-orcid":false,"given":"Patrick","family":"Ohlmann","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Wolff","sequence":"additional","affiliation":[{"name":"Neurology Department, Hautepierre Hospital, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Morel","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, H\u00f4pital Civil, Strasbourg University Hospital, 67000 Strasbourg, France"},{"name":"INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1161\/01.STR.24.1.35","article-title":"Classification of subtype of acute ischemic stroke. 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