Is Acute Ischemic Stroke Really Associated with Left Ventricular Systolic Dysfunction? A Case-Control Study
Mirabela M Manea1,2, Dorin Dragoș3,4, Sorin Tuță1,2
1Department of Neurology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Insights
Left ventricular systolic dysfunction (LVSD) was equally prevalent in acute ischemic stroke (AIS) patients and controls. However, LVSD was more common in AIS patients without atrial fibrillation (AF) compared to controls without AF.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Heart failure and acute ischemic stroke (AIS) share risk factors and pathophysiological mechanisms, contributing to high mortality.
- Left ventricular systolic dysfunction (LVSD) is a key indicator of heart failure and may influence stroke risk.
Purpose of the Study:
- To investigate the association between left ventricular systolic dysfunction (LVSD) and acute ischemic stroke (AIS).
- To determine if LVSD prevalence differs in AIS patients compared to a matched control group.
Main Methods:
- A prospective, matched case-control study involving 110 AIS patients and a control group matched for age, sex, and atrial fibrillation (AF) prevalence.
- Statistical analysis using Fisher's exact test to compare LVSD prevalence between groups.
Main Results:
- Overall LVSD prevalence did not differ significantly between AIS patients and controls.
- In patients without AF, normal systolic function was significantly more frequent in controls than in AIS patients (P = 0.036).
- No significant differences in LVSD were observed between cardioembolic and non-cardioembolic AIS, or between AIS patients with and without AF.
Conclusions:
- The study found no overall association between LVSD and AIS when matched for key demographic and clinical factors.
- A notable finding was a higher prevalence of LVSD in AIS patients without AF compared to controls without AF.
- These results suggest a complex relationship between LVSD, AF, and AIS, particularly in non-AF populations.
Context:
Heart failure and acute ischemic stroke (AIS) are frequently associated, due to similar risk factors and intertwined pathophysiologic mechanisms, and both result in a high mortality rate.
Aims:
Our objective was to demonstrate that left ventricular systolic dysfunction (LVSD) is associated with AIS.
Settings And Design:
Prospective matched, case-control study on 110 patients with AIS.
Methods And Material:
The patients in the control group (CG) without history of AIS and the same inclusion criteria were matched for age, sex, and atrial fibrillation (AF) prevalence.
Statistical Analysis Used:
Fisher's exact test was used for statistical analysis.
Results:
LVSD of any degree was not statistically more or less frequent in AIS patients than in the CG. The same was true if only the patients with AF were considered (the prevalence of LVSD was not significantly different in patients with AIS and AF than in controls with AF). However, among the patients without AF the proportion of patients with normal systolic function was significantly higher in the controls than in the AIS group (P = 0.036). There was no significant difference regarding LVSD either between the patients with cardioembolic AIS and those with noncardioembolic AIS or between the AIS patients with AF and AIS patients without AF.
Conclusions:
Our study concluded that the prevalence of LVSD was the same in AIS patients and controls matched for age, sex, and AF prevalence, although the prevalence of LVSD was indeed higher in AIS patients without AF than in controls without AF.
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