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Cardiac Function and Short-Term Outcome in Patients with Acute Ischemic Stroke: A Cross-Sectional Study
Tiffany L Mathias1, Karen C Albright1, Amelia K Boehme1
1Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).
Insights
Low left ventricular ejection fraction (LVEF) in ischemic stroke patients was not significantly linked to poorer short-term functional outcomes after accounting for other factors. Further research is needed to fully understand this relationship.
Area of Science:
- Cardiology
- Neurology
- Medical Research
Background:
- Limited research exists on the association between left ventricular ejection fraction (LVEF) and functional outcomes in ischemic stroke patients.
- Understanding factors influencing stroke recovery is crucial for patient management.
Purpose of the Study:
- To investigate if a reduced LVEF is associated with functional outcomes in patients following an ischemic stroke.
- To identify potential predictors of functional recovery after ischemic stroke.
Main Methods:
- A cross-sectional study analyzed 590 ischemic stroke patients.
- Left ventricular ejection fraction (LVEF) was assessed via echocardiography and categorized into normal, moderately low, and severely low groups.
- Statistical analyses included Chi-square, Wilcoxon rank sum, and logistic regression, adjusting for age, NIH Stroke Scale, and glucose levels.
Main Results:
- 79.8% of patients had normal LVEF, 10.8% moderately low, and 9.3% severely low.
- Initially, severely low LVEF appeared linked to poorer functional outcomes (26% vs. 40-45%, p=0.028).
- This association was not statistically significant after adjusting for covariates (OR 0.6, 95% CI 0.3-1.3, p=0.216).
Conclusions:
- Low LVEF was not found to be an independent predictor of short-term functional outcomes in ischemic stroke patients.
- The study highlights the complexity of factors influencing stroke recovery.
- Further investigation into cardiac function and stroke outcomes is warranted.
Abstract:
Few studies have investigated the relationship between left ventricular ejection fraction (LVEF) and functional outcome in ischemic stroke patients. The purpose of this study was to determine if a low LVEF in ischemic stroke was associated with functional outcome. A cross-sectional study was performed on ischemic stroke patients admitted to a single academic stroke center from June 2008 to December 2010. LVEF was determined using transthoracic or transesophageal echocardiography. Patients were categorized into three LVEF groups: severely low (<30%), moderately low (30-49%), and normal (>50%). Baseline demographics, in-hospital complications, and early outcomes were compared among LVEF groups using Chi-square, Wilcoxon rank sum, and logistic regression.590 patients met inclusion criteria (median age 65, 74% African American, 48% female). LVEF was normal in 79.8%, moderately low in 10.8%, and severely low in 9.3%. A smaller proportion of patients with severely low LVEF appeared to have good functional outcome compared to other groups (26% vs. 40% vs. 45%, p=0.028); however, this relationship was not significant after adjusting for age, baseline National Institute of Health Stroke Scale score and admission glucose (OR 0.6, 95% CI 0.3-1.3, p=0.216). Low LVEF was not an independent, significant predictor of short-term functional outcomes in ischemic stroke patients.
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