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Brain-heart axis--Review Article.

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Summary

Stroke can cause cardiac changes, including diastolic dysfunction, which predicts worse outcomes. Monitoring heart function and using NT-proBNP levels can improve stroke patient management and prognosis.

Keywords:
elevated cardiac enzymesheartstrokesudden death

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Area of Science:

  • Neurocardiology
  • Cardiovascular Medicine
  • Neurology

Background:

  • Stroke is increasingly recognized to cause cardiac alterations, including systolic and diastolic dysfunction.
  • Electrocardiographic abnormalities and arrhythmias are common in stroke patients, increasing mortality risk.
  • Elevated N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) may indicate higher risk of cardiac arrhythmias and mortality.

Purpose of the Study:

  • To review the pathological mechanisms linking heart and brain in stroke.
  • To discuss the clinical implications of cardiac changes following stroke.
  • To explore therapeutic strategies for managing cardiac complications in stroke patients.

Main Methods:

  • Review of existing literature on stroke-induced cardiac dysfunction.
  • Analysis of electrocardiographic and echocardiographic findings in stroke patients.
  • Evaluation of biomarkers such as NT-proBNP for risk stratification.

Main Results:

  • Ischemic stroke-induced systolic dysfunction is linked to high in-hospital mortality.
  • Cardiac diastolic dysfunction is a newly identified predictor of acute cerebrovascular events.
  • Increased sympathetic activity contributes to cardiac myocyte damage and enzyme release.
  • Frequent ECG abnormalities include ST segment changes, tachyarrhythmias (e.g., atrial fibrillation), and bradyarrhythmias.
  • High NT-proBNP levels correlate with increased risk of cardiac arrhythmias and mortality.

Conclusions:

  • Continuous electrocardiographic monitoring is crucial for identifying life-threatening arrhythmias in stroke patients.
  • NT-proBNP serves as a valuable discriminant marker for identifying high-risk patients.
  • Understanding heart-brain interactions is vital for improving stroke patient prognosis and management.