Acute cerebrovascular accident induces changes in left ventricular ejection fraction that vary based on underlying coronary artery disease, suggesting a stress-test-like response.
EF monitoring may aid short-term risk stratification post-stroke; hypothesis-generating for CAD-stratified cardiac responses.
The ejection fraction (EF) of the left ventricle was measured by radionuclide ventriculography in 64 patients during an acute cerebrovascular accident. Sixteen patients (12 with coronary artery disease) died within two weeks of the onset of symptoms and had only one EF measurement. In the remaining 48 patients, the EF was also measured two weeks and three months after the acute event. The ejection fraction of the patient who died soon after the acute stroke (52 +/- 18) was significantly lower than that of the patients who survived (64 +/- 10) (p less than 0.01). Of the patients who survived, 28 without history of coronary disease had an EF of 67 +/- 10 during the acute event. It was significantly higher than that measured after two weeks (60 +/- 10) p less than 0.01). In 10 patients with history of chronic stable angina pectoris, the EF (59 +/- 10) was significantly lower in the first study compared to that measured in the second (69 +/- 10) (p less than 0.02). Ten patients with no evidence of ischemia but with a history of myocardial infarction had a higher EF (61 +/- 11) during the first study as compared to the second (51 +/- 11) (p less than 0.05). In all patients there was no significant difference in the EF measurements between the second and the third study. It is suggested that the EF response of the left ventricle of the heart to the acute cerebrovascular accident is similar to that observed in a stress test.(ABSTRACT TRUNCATED AT 250 WORDS)
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Front et al. (1986) studied this question.
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