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Left ventricular non-compaction as a potential source for cryptogenic ischemic stroke in the young: A case-control

Pauli Pöyhönen1, Jouni Kuusisto1, Vesa Järvinen2

  • 1Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland.

Plos One
|August 16, 2020
PubMed

Insights

Left ventricular non-compaction is linked to increased risk of cryptogenic ischemic stroke in young adults. This finding holds true even without patent foramen ovale or cardiomyopathy, suggesting a novel stroke etiology.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Cryptogenic ischemic strokes affect up to 50% of young adults.
  • Patent foramen ovale (PFO) is a common but low-risk source of embolism.
  • Left ventricular (LV) non-compaction may cause stroke due to sluggish blood flow.

Purpose of the Study:

  • Investigate LV non-compaction as a source of cryptogenic stroke in young adults.
  • Assess the association between LV non-compaction and stroke etiology.
  • Determine if LV non-compaction is an independent risk factor for stroke.

Main Methods:

  • Prospective, multicenter case-control study (SECRETO; NCT01934725).
  • 30 young stroke cases (18-49 years) and 30 controls underwent cardiac magnetic resonance (CMR).
  • Transcranial Doppler (TCD) bubble test evaluated right-to-left shunt (RLS).

Main Results:

  • No significant differences in LV volumes, mass, or systolic function between groups.
  • LV non-compaction (mass and volume) was significantly higher in stroke cases.
  • Increased LV non-compaction and RLS were independently associated with cryptogenic stroke.

Conclusions:

  • LV non-compaction is a significant risk factor for cryptogenic ischemic stroke in young adults.
  • This association is independent of RLS and the absence of cardiomyopathy.
  • LV non-compaction represents a potential embolic source in young stroke patients.
Abstract

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