Echocardiographic parameters determining cardiovascular outcomes in patients after acute ischemic stroke

Area of Science:

• Cardiology
• Neurology
• Medical Imaging

Background:

• Previous prognostic studies in acute ischemic stroke (AIS) often examined limited echocardiographic parameters.
• Identifying robust predictors of adverse outcomes in AIS is crucial for effective secondary prevention.

Purpose of the Study:

• To investigate the prognostic value of multiple echocardiographic parameters, specifically left ventricular ejection fraction (LVEF) and aortic valve sclerosis (AVs), in patients with AIS.
• To assess the combined predictive power of LVEF and AVs for future major adverse cardiovascular events.

Main Methods:

• Retrospective review of 900 AIS patients who underwent transthoracic echocardiography.
• Assessment of composite clinical events (mortality, stroke, myocardial infarction, revascularization) during a median follow-up of 3.3 years.
• Multivariable Cox regression analyses were performed to identify independent prognostic factors, controlling for confounders.

Main Results:

• Reduced LVEF (<62%) and the presence of AV sclerosis were identified as independent predictors of composite clinical events.
• Patients with both reduced LVEF and AV sclerosis had a significantly higher risk of adverse outcomes (HR 2.6-fold higher than the lowest-risk group).
• The inclusion of LVEF and AVs significantly improved the predictive accuracy of a clinical model for outcome prediction.

Conclusions:

• In patients with AIS, LVEF <62% and AV sclerosis are significant independent prognostic markers for future vascular events.
• These echocardiographic findings enhance the prediction of adverse outcomes beyond traditional clinical risk factors.
• AIS patients with reduced LVEF and AV sclerosis may benefit from intensified secondary prevention strategies.