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Left ventricular systolic dysfunction and the risk of ischemic stroke in a multiethnic population

Allison G Hays1, Ralph L Sacco, Tanja Rundek

  • 1Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA.

Stroke
|June 3, 2006
PubMed

Insights

Left ventricular dysfunction (LVD), even mild, significantly increases ischemic stroke risk in the general population. Echocardiography assessment of LV function is crucial for stroke risk evaluation.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Left ventricular dysfunction (LVD) is a known risk factor for cardiovascular mortality.
  • The association between LVD and ischemic stroke, particularly in the general population and for mild LVD, requires further investigation.

Purpose of the Study:

  • To investigate the relationship between left ventricular dysfunction (LVD) and the risk of ischemic stroke.
  • To determine if mild LVD poses a significant stroke risk in a multiethnic cohort.

Main Methods:

  • Transthoracic 2-dimensional echocardiography was used to assess LV systolic function in 270 ischemic stroke patients and 288 controls from the Northern Manhattan Study (NOMAS).
  • Left ventricular ejection fraction was categorized as normal, mildly, moderately, or severely decreased.
  • Logistic regression analysis, adjusted for established stroke risk factors, was employed to evaluate the association between impaired ejection fraction and ischemic stroke.

Main Results:

  • Left ventricular dysfunction (LVD) was significantly more prevalent in stroke patients (24.1%) compared to controls (4.9%).
  • A decreased ejection fraction was independently associated with an increased risk of ischemic stroke, with adjusted odds ratios ranging from 3.88 to 3.96 for all degrees of LVD.
  • This association was consistent across all age, gender, and race-ethnicity subgroups.

Conclusions:

  • Left ventricular dysfunction (LVD), including mild cases, is an independent predictor of ischemic stroke risk.
  • Evaluating left ventricular function should be an integral part of comprehensive stroke risk assessment.
Abstract

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