Left ventricular wall motion abnormalities are associated with stroke recurrence
Jeong-Yoon Choi1, Jaehyung Cha1, Jin-Man Jung1
1From the Department of Neurology (J.-Y.C.), Seoul National University College of Medicine, Seoul National University Bundang Hospital; Medical Science Research Center (J.C.) and Department of Neurology (J.-M.J.), Korea University College of Medicine, Korea University Ansan Hospital, Gyeonggi-do; Department of Neurology (W.-K.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (K.O.), Korea University College of Medicine, Korea University Guro Hospital, Seoul; and Department of Neurology (K.-H.C., S.Y.), Korea University College of Medicine, Korea University Anam Hospital, Seoul.
Objective:
To investigate the role of left ventricular wall motion abnormalities (LVWMA), unrelated to high-risk cardioembolic conditions, in stroke recurrence.
Methods:
This study included consecutive acute ischemic stroke patients. Transthoracic echocardiography was performed as a routine evaluation for stroke patients. The outcomes were the time to recurrent any stroke and ischemic stroke.
Results:
Among 4,316 acute ischemic stroke patients, 430 had LVWMA without high-risk cardioembolic sources. The median observation periods of patients at risk of any stroke and ischemic stroke were 24.5 and 24.7 months. During the follow-up, any stroke and ischemic stroke recurrence were observed in 310 (7.2%) and 250 (5.8%) patients. LVWMA were associated with outcomes after adjustment for traditional cardiovascular risk factors, laboratory and imaging variables, and therapeutic interventions (hazard ratio [HR] 1.707, 95% confidence interval [CI] 1.262-2.310 for any stroke; HR 1.709, 95% CI 1.222-2.390 for ischemic stroke). Moreover, LVWMA could still be considered as independent risk factors after correction for covariates that were significantly associated with outcomes in univariable regression (HR 1.747, 95% CI 1.292-2.364 for any stroke; HR 1.704, 95% CI 1.219-2.382 for ischemic stroke). There were no significant interactions between LVWMA and outcomes between the subgroups except for the statin treatment subgroup.
Conclusions:
This study suggests that LVWMA, even when unassociated with high-risk cardioembolic sources, could be an independent predictor for stroke recurrence in patients with ischemic stroke.
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