Key result
In patients with acute ischemic stroke, elevated hs-cTnI was associated with lower LVEF compared to normal troponin levels.
Why the study?
Neurogenic myocardial injury occurs due to autonomic nervous system dysregulation, prompting exploration of the frequency of elevated troponin and dynamic ST segment/T wave changes and their relation with LV systolic functions in acute ischemic stroke.
Observational (n=125)
In acute ischemic stroke, elevated troponin and ST/T wave changes are common and associated with lower LVEF, suggesting neurogenic stunned myocardium.
Answers are grounded in this paper and cite their sources.
May prompt echocardiography in troponin-positive acute stroke; leaves open prognostic and therapeutic implications.
BACKGROUND AND PURPOSE: Neurogenic myocardial injury occurs as a result of dysregulation of autonomic nervous system. The aim of this study was to explore the frequency of elevated troponin and dynamic ST segment/T wave changes and their relation with left ventricular (LV) systolic functions in acute ischemic stroke patients. METHODS: One hundred and twenty-five patients (mean age: 65.1±15.2years, 76 male) presenting with acute ischemic stroke were consecutively included. 12-lead electrocardiogram was taken to assess dynamic ST segment/T wave changes, conventional transthoracic echocardiography to determine LV ejection fraction (LVEF). High-sensitive cardiac troponin I (hs-cTnI) level>0.04ng/mL was accepted as elevated. RESULTS: Twenty-seven patients (21.6%) had elevated hs-cTnI and 60 patients (48%) had dynamic ST segment/T wave changes. The stroke patients with elevated hs-cTnI had significantly higher NT-proBNP values (2302±3450pg/mL vs 799±2075pg/mL p<0.001) and higher frequency of ST segment/T wave changes (85.2% vs 37.8% p<0.001), and lower LVEF (52.2±13.6% vs 61.0±8.5% p=0.002) compared to patients with normal troponin levels. The patients with ST segment/T wave changes had significantly higher frequencies of hyper-lipidemia (31.7% vs 15.4% p=0.031) and coronary artery disease (CAD) (43.3% vs 13.8% p<0.001), hs-cTnI (0.19±0.55ng/mL vs 0.02±0.01ng/mL p<0.001) and NT-proBNP levels (1430±2564pg/mL vs 842±2425pg/mL p=0.016), and lower LVEF (56.1±11.7% vs 61.9±8.3% p=0.009). Linear regression analysis revealed presence of CAD, but not ST segment/T wave changes as an independent predictor of hs-cTnI (p=0.034). LVEF was independently associated with hs-cTnI (p=0.003) and presence of CAD (p=0.009) when adjusted by age, sex and presence of ST segment/T wave changes. CONCLUSION: Troponin elevation and ST segment/T wave changes occurring in patients suffering acute ischemic stroke, especially in those with CAD, may be a sign of neurogenic stunned myocardium.
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İleri et al. (2022) conducted an observational in acute ischemic stroke (n=125). Elevated hs-cTnI (>0.04 ng/mL) vs. Normal hs-cTnI was evaluated on Left ventricular ejection fraction (LVEF) (p=0.002). In patients with acute ischemic stroke, elevated hs-cTnI was associated with lower LVEF compared to normal troponin levels.
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