Key result
Lower ejection fraction was an independent predictor of poor functional status at 30 days after acute stroke (RR 4.68).
Why the study?
To evaluate the effect of low EF and left ventricular systolic or diastolic dysfunction on day-1 neurological state and 30-day post-stroke functional status.
Does low ejection fraction or left ventricular dysfunction affect neurological and functional status in acute stroke patients?
Observational (n=162)
Does low ejection fraction or left ventricular dysfunction affect neurological and functional status in acute stroke patients?
Effect estimate: RR 4.68 (95% CI 1.22-18.00)
p-value: p=0.0186
Left ventricular systolic dysfunction and lower ejection fraction are independent predictors of worse neurological and functional outcomes in acute stroke patients.
Low EF may predict poor post-stroke function; leaves open whether cardiac optimization improves outcomes.
INTRODUCTION: Cardiologic diagnostics in stroke patients is designed to identify heart disease as a potential cause of stroke. The aim of this study was to evaluate the effect of low ejection fraction (EF) and left ventricular systolic/diastolic dysfunction (LVSD, LVDD) on the neurological state on the 1st day of stroke, as well as post-stroke functional status at 30 days after stroke. PATIENTS AND METHODS: For a prospective study, 162 stroke patients (mean age 74 years) were qualified. They were analysed according to neurological state on the 1st day of stroke, the results of transthoracic echocardiography, and functional status at 30 days after stroke. RESULTS: The neurological state on the 1st day after stroke was significantly worse in patients with LVSD. In patients with reduced EF, functional status was significantly worse at 30 days after stroke. Patients with E/A 0.8-2 had a significantly worse functional status compared to patients with E/A < 0.8. Individuals with E/A 0.8-2 and segmental LVSD or EF < 50% had significantly worse functional status compared to patients without LVSD. An independent factor for moderate/severe status was identified: E/A > 0.8 (RR 3.28 [95% CI 1.15-9.37]); independent factors for poor functional status were lower EF (RR 4.68 [95% CI 1.22-18.00]) and age (RR 4.68 [95% CI 1.22-11.00]). CONCLUSIONS: One quarter of patients in the acute phase of stroke have LVSD and/or LVDD. LVSD adversely affects both neurological status in acute stroke as well as functional status in the short-term follow-up. Age at first-in-life stroke incidence and lower EF are predictors of poor functional status one month after a stroke.
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Lasek‐Bal et al. (2019) conducted an observational in Acute stroke (n=162). Lower ejection fraction vs. Normal ejection fraction was evaluated on Poor functional status (mRS 3-6) at 30 days (RR 4.68, 95% CI 1.22-18.00, p=0.0186). Lower ejection fraction was an independent predictor of poor functional status at 30 days after acute stroke (RR 4.68).
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