Abstract W P192: Echocardiographic findings in Acute Ischemic Stroke are Implicated in Specific Subtypes of Ischemic Stroke
Background & Significance: Echocardiographic left ventricular hypertrophy (LVH) and left atrial enlargement (LAE) reflect mortality and morbidity from cardiovascular disease. We aimed to investigate the association between echocardiographic findings and stroke subtypes and its implication in acute ischemic stroke.
Methods: We retrospectively reviewed the records of 1692 patients with acute ischemic stroke, who were admitted within 7 days after symptom onset. Stroke subtypes were categorized according to the SSS-TOAST classification. LVH was defined as left ventricular mass index (LVMI) >115 g/m2 in men and >95 g/m2 in women, and moderate to severe LAE was defined as left ventricular volume index (LAVi) ≥34 ml/m2 in both gender. The demographic data and echocardiographic findings [LVMI, LAVi, and left atrial anterior-posterior diameter (LAD) and presence of LVH or LAE] were compared in each stroke subtype.
Results: A total of 1002 patients who were classified as patients with large-artery atherosclerosis (LAA, n=525), patients with cardioembolism (CE, n=296), and patients with small vessel occlusion (SVO, n=181) were included. Echocardiographic variables showed trends in which larger LVMI, LAD, and LAVi in CE group compared with two other groups. Multivariate analysis was performed as comparison with SVO after adjusting for age, gender, hyperlipidemia, diabetes mellitus, and history of smoking. LVH and LVMI were significant independent predictors of LAA (OR 1.6, 95%CI 1.0-2.5, p=0.04 in LVH and OR 1.1, 95%CI 1.0-1.2 by increased LVMI 10g/m2, p=0.036), and all of moderate-to-severe LAE, LVH, LVMI, LAD and LAVi were significant independent predictors of CE (OR 16.7, 95%CI 8.3-33.7, p<0.001 in LAE; OR 2.4, 95%CI 1.5-3.8, p<0.001 in LVH; OR 1.2, 95%CI 1.11-1.3 by increased LVMI 10g/m2, p<0.001; OR 1.2, 95%CI 1.1-1.2 by increased LAD 1 mm, p<0.001; OR 1.2, 95%CI 1.1-1.2 by increased LAVi 1 ml/m2, p<0.001).
Conclusions: Our studies demonstrate echocardiographic LVMI, LAD and LAVi are linked to specific stroke subtypes even after adjusting for established cardiovascular risk. These results suggest that consideration of echocardiographic indices is helpful to understand the pathomechanism in the ischemic stroke.
Author Disclosures: J. Lee: None. J. Kwon: None. N. Kim: None. H. Noh: None.
- © 2015 by American Heart Association, Inc.