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Cardiac function and outcome in patients with cardio-embolic stroke

Authors
 Jung-Ick Byun  ;  Keun-Hwa Jung  ;  Young-Dae Kim  ;  Jeong-Min Kim  ;  Jae-Kyu Roh 
Citation
 PLOS ONE, Vol.9(4) : e95277, 2014 
Journal Title
PLOS ONE
Issue Date
2014
MeSH
Aged ; Echocardiography ; Female ; Heart/physiopathology* ; Humans ; Male ; Middle Aged ; Stroke/physiopathology* ; Stroke Volume/physiology
Abstract
BACKGROUND:
The relationship between whole spectrum of Ejection fraction (EF) and cardioembolic stroke (CES) outcome has not been fully described yet. Notably, it remains unclear whether borderline EF (41∼49%) is related with poor outcome after CES. We sought to evaluate whether lower ejection fraction and borderline EF could predict the outcome in patients with CES.
METHOD AND RESULTS:
We evaluated the relationship between EF and functional outcome in 437 consecutive patients with CES. EF was introduced as continuous and categorical (EF≤40%, EF 41∼49%, EF≥50%) variable. Patients with CES and the subgroup with AF were evaluated separately. Poor short-term outcome (modified Rankin Score≥3at discharge or death within 90 days after stroke onset) and long-term mortality were evaluated. A total of 165 patients (37.8%) had poor short-term outcomes. EF tends to be lower in patients with poor short-term outcome (56.8±11.0 vs. 54.8±12.0, p-value 0.086). Overall cumulative death was136 (31.1%) in all CES patients and 106 (31.7%) in the AF subgroup. In a multivariable model adjusted for possible covariates, the hazard ratio for mortality significantly decreased by 3% for every 1% increase in ejection fraction in CES patients and 2% for every 1% increase in the AF subgroup. Reduced EF (EF≤40%) showed higher mortality (HR 2.61), and those with borderline EF (41∼49%) had a tendency of higher mortality (HR 1.65, p-value 0.067)compared with those with normal EF.
CONCLUSION:
We found a strong association between lower EF and CES outcome. Echocardiographic evaluation helps to better determine the prognosis in CES patients, even in subgroup of patients with AF.
Files in This Item:
T201401399.pdf Download
DOI
10.1371/journal.pone.0095277
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98751
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