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The International Journal of Cardiovascular Imaging

Published in:

01-08-2020 | Stroke | Original Paper

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

Published in: The International Journal of Cardiovascular Imaging | Issue 8/2020

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.

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Title: 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
Publication date: 01-08-2020
Publisher: Springer Netherlands
Keywords: Stroke
Transthoracic Echocardiography
Published in: The International Journal of Cardiovascular Imaging / Issue 8/2020
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-020-01841-5

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