Abstract W P290: Left Ventricular Diastolic Dysfunction Deters Functional Recovery After Acute Ischemic Stroke
Background: Diastolic dysfunction of left ventricle (LV) is associated with heart failure symptoms and restricts exercise capacity even in patients with preserved LV ejection fraction. LV diastolic dysfunction is readily evaluated by the conventional Doppler echocardiography. We hypothesized that LV dysfunction may deter functional recovery and increase vascular events in acute ischemic stroke patients.
Methods: From a total of 4808 patients who admitted to a tertiary academic hospital between August 2007 and June 2013, we selected image-documented cases (N=3858) and subjects with echocardiographic evaluation within 1 month before or after the index stroke (N=3175; 66% of the eligible population). We excluded cases without adequate echocardiographic data for evaluation of LV diastolic dysfunction (N=213) and mRS score at 3 months (N=17). LV diastolic dysfunction was graded into 4 groups in accordance with the current guideline: normal (including restricted patterns), grade 1, grade 2 and grade 3 dysfunction. Recurrent vascular events and mRS score at 3 months were collected prospectively as a quality improvement program of stroke care. Functional dependency or death was defined as a mRS score 2 - 6.
Results: Among the 2945 included subjects, male was 1784 (61%) and the mean age was 67 ± 13 years. Recurrent events until 3 months included 197 (7%) recurrent strokes and 246 (8%) composite events. Functional dependency or death at 3 months was documented in 1384 (47%) cases. Cases with LV diastolic dysfunction were more likely to be female, old, higher prevalence of vascular risk factors, and more severe neurological deficit at admission. A multivariable logistic regression model taking functional dependency or death as a dependent variable showed that LV diastolic dysfunction remained significant after adjusting for relevant covariates as follows: grade 1 dysfunction (adjust OR [95% CI]; 1.23 [1.01 - 1. 50]), grade 2 (1.24 [0.92 - 1.68]) and grade 3 (1.76 [1.19 - 2.60]). However, there was no association between LV diastolic dysfunction and vascular events.
Conclusion: LV diastolic dysfunction may independently hinder functional recovery after ischemic stroke.
Author Disclosures: H. Park: None. B. Kim: None. M. Yang: None. S. Kim: None. M. Han: None. H. Bae: None.
- © 2015 by American Heart Association, Inc.