Key result
Subacute ischemic stroke patients demonstrated significant differences in stroke volume index and systemic vascular resistance index compared to healthy controls during cycling exercise (P<0.01).
Why the study?
Cardiac dysfunction accompanies acute ischemic stroke and affects early rehabilitation, but reference hemodynamic data on cardiac function in the subacute phase are lacking.
Do non-invasive cardiac output parameters differ between subacute ischemic stroke inpatients and healthy controls during cycling exercise?
Observational (n=21)
Do non-invasive cardiac output parameters differ between subacute ischemic stroke inpatients and healthy controls during cycling exercise?
Non-invasive cardiac output monitoring during cycling exercise reveals significant cardiac dysfunction in subacute ischemic stroke patients, characterized by increased peripheral vascular resistance and limited myocardial systolic function.
May inform cardiac monitoring during subacute stroke rehab; leaves open need for larger validation trials.
BACKGROUND: Cardiac dysfunction accompanies acute ischemic stroke and affects the effective implementation of early rehabilitation interventions. There is a lack of reference hemodynamic data on cardiac function in the subacute phase of ischemic stroke. OBJECTIVE: In this study, we aimed to identify appropriate cardiac parameters for exercise training utilizing a pilot study. METHODS: We used a transthoracic electrical bioimpedance non-invasive cardiac output measurement (NICOM) device to monitor cardiac function in real time for two groups [i.e., subacute ischemic stroke inpatients group (n= 10) and healthy control group (n= 11)] using a cycling exercise experiment. The parameters of both groups were compared to highlight the cardiac dysfunction in the subacute phase in patients with ischemic stroke. RESULTS: We considered stroke volume index (SVI) and systemic vascular resistance index (SVRi) as the primary outcomes, and there was significant intragroup difference (stroke group: P< 0.001; control group: P< 0.001, using one-way ANOVA) and significant intergroup difference at each individual time segment (P< 0.01, using independent t-test). Among the secondary outcomes, i.e., cardiac index (CI), ejection fraction (EF), end-diastolic volume (EDV), and cardiac contraction index (CTI), we found significant intergroup differences in CI, EF, and CTI scores (P< 0.01, using independent t-test). Significant interaction with respect to time and group were seen only in the SVRi and CI scores (P< 0.01, using two-way ANOVA). There was no significant inter- or intra-group differences in EDV scores. CONCLUSION: SVRI, SVI, and CI values highlight cardiac dysfunction in stroke patients the most. At the same time, these parameters suggest that cardiac dysfunction in stroke patients may be closely related to the increased peripheral vascular resistance caused by infarction and the limitation of myocardial systolic function.
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Yang et al. (2023) conducted an observational in Subacute ischemic stroke (n=21). Subacute ischemic stroke vs. Healthy controls was evaluated on Stroke volume index (SVI) and systemic vascular resistance index (SVRi) (p=<0.01). Subacute ischemic stroke patients demonstrated significant differences in stroke volume index and systemic vascular resistance index compared to healthy controls during cycling exercise (P<0.01).
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