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(Stroke. 2006;37:1637.)
© 2006 American Heart Association, Inc.

Editorials

Heart Failure and Stroke

Peter Appelros, MD, PhD

From the Department of Neurology, Örebro University Hospital, Örebro, Sweden; and the Neurotec Department, Karolinska Institutet, Stockholm, Sweden.

Correspondence to Dr Peter Appelros, Department of Neurology, Örebro University Hospital, SE-701 85 Örebro, Sweden. E-mail peter.appelros@orebroll.se

Key Words: case control studies • cerebrovascular accident • heart failure, congestive

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 1715–1719

Heart failure (HF) has been recognized as a risk factor for stroke since the 70s.¹ Results from a population-based stroke study have shown that HF is an independent risk factor for severe strokes.² It seems likely that many HF-related strokes are embolic, but few studies have evaluated the use of anticoagulation therapy in these patients. At present we are awaiting the results of 2 studies, which aim at defining the optimum antithrombotic therapy for patients with HF.^3,4

Ejection fraction (EF) is an echocardiographic measure of left ventricular systolic function. Normal value of EF is 50% to 70%, but only half of individuals having an EF 30% have clinical overt HF.⁵ More uncommonly, clinical HF may exist in diastolic relaxation failure when EF is normal. At which point does the stroke risk begin to increase? Few studies have been made in this area. In the Survival and Ventricular Enlargement study (SAVE), there was an 18% increase in the risk of stroke for every reduction of 5% in EF.⁶ It is not fully clear, however, within which limits this relationship is valid. A limitation to the generalizability of that study is that all patients had had a myocardial infarction. In the Studies of Left Ventricular Dysfunction study (SOLVD), patients having an EF 35% were included. A 58% increase of thromboembolic events for every 10% decrease in EF was found in women, but not in men. That study was retrospective.

New studies within this area are therefore . . . [Full Text of this Article]

Related Article:

Left Ventricular Systolic Dysfunction and the Risk of Ischemic Stroke in a Multiethnic Population

Allison G. Hays, Ralph L. Sacco, Tanja Rundek, Robert R. Sciacca, Zhezhen Jin, Rui Liu, Shunichi Homma, and Marco R. Di Tullio
Stroke 2006 37: 1715-1719. [Abstract] [Full Text] [PDF]