Evidence map›Paper›PMID 41614489›Full record

ArticleEuropean stroke journal2026

Focused cardiac ultrasound conducted by neurologists in patients with stroke: A validation study.

Jorge Pagola, Piergiorgio Lochner, Radim Licenik, Giulio Maria Fiore, Felipe A Montellano, Victor Gonzalez, Valérie Pavlicek, Juan Alvarez-Cienfuegos, Sergio Moral, Roberto Muñoz Arrondo and 17 more

Abstract readMulticenter StudyValidation Study
In one paragraph

Article in European stroke journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Jorge PagolaVall d'Hebron University Hospital, Stroke Unit, Neurology Department, Barcelona, Spain.
Piergiorgio LochnerFaculty of Medicine, Saarland University Hospital and Saarland University, Homburg, Saarland, Germany.
Radim LicenikNorth West Anglia NHS Foundation Trust, Neurology and Cardiology Department, Edith Cavell Campus, Peterborough, Cambridgeshire, UK.
Giulio Maria FioreVall d'Hebron University Hospital, Stroke Unit, Neurology Department, Barcelona, Spain.ORCID 0009-0005-4055-984X
Felipe A MontellanoInstitute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany.ORCID 0000-0002-9438-0854
Victor GonzalezCardiology Department, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0001-7243-0876
Valérie PavlicekFaculty of Medicine, Saarland University Hospital and Saarland University, Homburg, Saarland, Germany.
Juan Alvarez-CienfuegosNeurology Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain.ORCID 0000-0003-1604-2179
Sergio MoralCardiology Department, Hospital Universitari de Girona DC Josep Trueta, Girona, Spain.
Roberto Muñoz ArrondoNeurology Department, Hospital de Navarra, Pamplona, Navarra, Spain.
Alberto VeraCardiology Department, Hospital de Navarra, Pamplona, Navarra, Spain.ORCID 0000-0003-2181-0961
Angel RuizNeurology Department, Puerta de Hierro Majadahonda University Hospital, Majadahonda, Madrid, Spain.ORCID 0009-0002-2924-2057
Jesús González MirelisCardiology Department, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Madrid, Spain.ORCID 0000-0002-3083-8627
Jorge Rodríguez-PardoDepartment of Neurology and Stroke Center, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain.
Esther Pérez-DavidDepartment of Cardiology, Hospital La Paz Institute for Health Research-IdiPAX, Madrid, Spain.
Juan Manuel García-SánchezNeurology Department, Hospital Universitario de Basurto-OSI Bilbao, Bilbao, País Vasco, Spain.ORCID 0009-0007-0237-8313
Lara Ruiz GómezCardiology Department, Hospital Universitario de Basurto-OSI Bilbao, Bilbao, País Vasco, Spain.
Laura Amaya PascasioNeurology Department, Complejo Hospitalario Torrecardenas Servicio de Neurologia, Hermandad donantes de sangre S/N Almeria, Spain.ORCID 0000-0003-1162-4209
Elvira Carrión RíosCardiology Department, Complejo Hospitalario Torrecardenas Servicio de Cardiologia, Hermandad donantes de sangre S/N Almeria, Spain.
Tania Rodriguez-AresNeurology Department, Hospital Universitario Lucus Augusti, Lugo, Galicia, Spain.
Charigan AbouCardiology Department, Hospital University Lucus Augusti, Lugo, Galicia, Spain.
María PayáNeurology Department, Hospital General Universitario de Albacete, Albacete, Castilla-La Mancha, Spain.
Laura GuerraCardiology Department, Hospital General Universitario de Albacete, Albacete, Castilla-La Mancha, Spain.
Ana de ArceNeurology Department, Donostia University Hospital, Donostia, Gipuzkoa, Spain.
Ainhoa Benegas ArosteguiCardiology Department, Donostia University Hospital, Donostia, Gipuzkoa, Spain.
Muhammad Khaled HasanNorth West Anglia NHS Foundation Trust, Neurology and Cardiology Department, Edith Cavell Campus, Peterborough, Cambridgeshire, UK.
Vlatka ReskovicCardiology Department, University Hospital Centre Zagreb, Zagreb, Croazia.ORCID 0000-0002-4721-3236

Funding

Spanish Society of Neurosonology (SONES)World organization of Neurosonology/European Society of Cerebral Hemodynamics and Neurosonology (WON/ESNCH)
6 · The paper itself

Abstract

introductionFocused cardiac ultrasound (FoCUS) has a high diagnostic yield and a rapid theoretical learning curve. FoCUS can be applied in stroke assessments performed by stroke neurologists when a cardioembolic stroke is suspected. PATIENTS AND

methodsAn international multicenter, prospective validation study was conducted to assess neurologists' ability to perform FoCUS. The FoCUS examination was defined as a simplified 2D transthoracic echocardiography. Neurologists and cardiologists performed the FoCUS independently and blinded. A twenty-question test evaluated neurologists' ability to recognize sources of cardioembolic stroke from recorded FoCUS studies.

resultsA total of 432 paired studies involving 216 patients were conducted across 11 centers. No significant differences were found between neurologists and cardiologists in detecting: Left Ventricle (LV) dysfunction (7.4% vs 7.9%, p = 0.834), LV dilation (2.8% vs 2.3%, p = 0.766), VC collapsibility (7.2% vs 9.1%, p = 0.501), Right Ventricle dysfunction (0.9% vs 0.9%, p = 0.999), and pericardial effusion (0.5% vs 1.9%, p = 0.212). Cohen Kappa showed substantial agreement for LV dysfunction (0.640), moderate for LV dilation (0.589), and fair for VC collapsibility (0.226). Neurologists demonstrated 93.82% sensitivity and 92.92% specificity for detecting embolic sources. Success rate for LV akinesia was 88% (16/18), LV dysfunction 83% (15/18), complex aortic plaque 88% (16/18), and mitral stenosis 55% (10/18). DISCUSSION AND

conclusionProperly trained neurologists can reliably perform FoCUS, particularly for assessing LV function and dilation, with better results in patients with favorable echocardiographic windows. While VC assessment requires further training, neurologists demonstrated high accuracy in identifying cardioembolic sources (over 90% of cases correctly identified). This study supports implementing standardized FoCUS training for neurologists through collaboration with cardiology specialists to enhance stroke diagnostics and management.

Indexed as

EchocardiographyNeurologistsStrokeAgedFemaleHumansMaleMiddle AgedProspective StudiesakinesiaEchocardiographyFoCUSleft ventricle dysfunctionsources of strokestroke

Identifiers

PMID41614489
PMCPMC12866232

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