Academic Journal
Acute right insular ischaemic lesions and poststroke left ventricular dysfunction
| العنوان: | Acute right insular ischaemic lesions and poststroke left ventricular dysfunction |
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| المؤلفون: | Stephan Achenbach, Arnd Dörfler, Stefan Schwab, Max J Hilz, Bernd Kallmünzer, Klemens Winder, Carolina Villegas Millar, Gabriela Siedler, Michael Knott, Anna Engel, Frank Seifert, Kilian Fröhlich |
| المصدر: | Stroke and Vascular Neurology, Vol , Iss |
| بيانات النشر: | BMJ Publishing Group |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Neurology. Diseases of the nervous system, RC346-429 |
| الوصف: | Introduction Myocardial injury related to acute ischaemic stroke is common even without primary cardiac disease. We intended to determine associations between values of left ventricular ejection fraction (LVEF) and ischaemic stroke lesion sites.Methods Of a local database, patients with acute first-ever ischaemic stroke confirmed by brain imaging but without pre-existing heart disease were included. The cardiac morphology and LVEF were obtained from transthoracic or transesophageal echocardiography, and impaired LVEF was categorised as mild (35%–50%), moderate (34%–25%) and severe (<25%). Patient age, stroke severity, ischaemic lesion volume, prevalence of troponin I increase (>0.1 ng/mL), atrial fibrillation and cardiac wall motion abnormalities were assessed and compared between patients with and without impaired LVEF after stroke (significance: p<0.05). A multivariate voxelwise lesion analysis correlated LVEF after stroke with sites of ischaemic lesions.Results Of 1209 patients who had a stroke, 231 (mean age 66.3±14.0 years) met the inclusion criteria; 40 patients (17.3%) had an impaired LVEF after stroke. Patients with impaired LVEF had higher infarct volumes (53.8 mL vs 30.0 mL, p=0.042), a higher prevalence of troponin increase (17.5% vs 4.2%, p=0.006), cardiac wall motion abnormalities (42.5% vs 5.2%, p<0.001) and atrial fibrillation (60.0% vs 26.2%, p<0.001) than patients with LVEF of >50%. The multivariate voxelwise lesion analysis yielded associations between decreased LVEF and damaged voxels in the insula, amygdala and operculum of the right hemisphere.Conclusion Our imaging analysis unveils a prominent role of the right hemispheric central autonomic network, especially of the insular cortex, in the brain–heart axis. Our results support preliminary evidence that acute ischaemic stroke in distinct brain regions of the central autonomic network may directly impair cardiac function and thus further supports the concept of a distinct stroke-heart syndrome. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2059-8696 |
| Relation: | https://svn.bmj.com/content/early/2023/01/17/svn-2022-001724.full; https://doaj.org/toc/2059-8696; https://doaj.org/article/9bab9f8ec4bc4e6f93fb9b29d63ebea3 |
| DOI: | 10.1136/svn-2022-001724 |
| الاتاحة: | https://doi.org/10.1136/svn-2022-001724 https://doaj.org/article/9bab9f8ec4bc4e6f93fb9b29d63ebea3 |
| رقم الانضمام: | edsbas.D19CC8E1 |
| قاعدة البيانات: | BASE |
| تدمد: | 20598696 |
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| DOI: | 10.1136/svn-2022-001724 |