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Echocardiographic parameters determining cardiovascular outcomes in patients after acute ischemic stroke

Authors
 Minkwan Kim  ;  Hack-Lyoung Kim  ;  Kyung-Taek Park  ;  You Nui Kim  ;  Jae-Sung Lim  ;  Woo-Hyun Lim  ;  Jae-Bin Seo  ;  Sang-Hyun Kim  ;  Myung-A Kim  ;  Joo-Hee Zo 
Citation
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, Vol.36(8) : 1445-1454, 2020-08 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 
ISSN
 1569-5794 
Issue Date
2020-08
MeSH
Aged ; Aged, 80 and over ; Aortic Valve / diagnostic imaging* ; Aortic Valve / physiopathology ; Brain Ischemia / diagnostic imaging ; Brain Ischemia / mortality ; Brain Ischemia / therapy* ; Cause of Death ; Echocardiography, Doppler, Color* ; Female ; Heart Valve Diseases / diagnostic imaging* ; Heart Valve Diseases / mortality ; Heart Valve Diseases / physiopathology ; Heart Valve Diseases / therapy ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sclerosis ; Stroke / diagnostic imaging ; Stroke / mortality ; Stroke / therapy* ; Stroke Volume ; Time Factors ; Treatment Outcome ; Ventricular Dysfunction, Left / diagnostic imaging* ; Ventricular Dysfunction, Left / mortality ; Ventricular Dysfunction, Left / physiopathology ; Ventricular Dysfunction, Left / therapy ; Ventricular Function, Left
Keywords
Acute ischemic stroke ; Aortic valve sclerosis ; Left ventricular ejection fraction ; Transthoracic echocardiography
Abstract
Previous studies have focused on only 1 or 2 echocardiographic parameters as prognostic markers in patients with acute ischemic stroke (AIS). A total of 900 patients with AIS who underwent transthoracic echocardiography (72.6 ± 12.0 years and 60% males) were retrospectively reviewed. Composite clinical events, including all-cause mortality, non-fatal stroke, non-fatal myocardial infarction, and coronary revascularization, were assessed during clinical follow-ups. During a median follow-up of 3.3 years (interquartile range 0.6-5.1 years), there were 151 (16.8%) composite events. In the multivariable analyses after controlling for potential confounders, left ventricular ejection fraction (LVEF) < 62% (hazard ratio [HR] 1.62; 95% confidence interval [CI] 1.14-2.30; p = 0.007) and AV sclerosis (AVs) (HR 1.56; 95% CI 1.10-2.21; p = 0.013) were independent prognostic factors associated with composite events. Multivariable analyses showed that HR for composite events gradually increased according to LVEF and AVs: HR was 2.6-fold higher in the highest-risk group than in the lowest group (p < 0.001). Compared with a clinical model (global chi-square = 69.6), LVEF, AVs, and both of them were significantly improved outcome prediction in sequential Cox model analysis (global chi-square = 75.6, 75.7, and 78.8, respectively; p < 0.05 for each) for each. In patients with AIS, LVEF < 62%, and the presence of AV sclerosis can predict future vascular events. Patients with AIS exhibiting reduced LVEF and AV sclerosis may benefit from aggressive secondary prevention.
Full Text
https://link.springer.com/article/10.1007/s10554-020-01841-5
DOI
10.1007/s10554-020-01841-5
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Minkwan(김민관) ORCID logo https://orcid.org/0000-0002-4079-8219
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179802
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