Abstract T MP42: Mitral Ratio of Peak Early to Late Diastolic Filling Velocity as a Predictor of Mortality in Acute Ischemic Stroke

Abstract

Background: Diastolic dysfunction has a significant impact on symptoms, functional outcomes, and prognosis in ischemic stroke patients. The ratio of peak early to late diastolic filling velocity (E/A) is the simplest and most commonly used index to assess diastolic dysfunction. Methods: One thousand seven hundred seven patients with acute ischemic stroke who had a transthoracic echocardiogram during admission were identified. We classified patients into 3 groups by E/A ratios based on the previous literature search. We conducted binary logistic regression analysis for death, vascular death, and stroke death. Results: Among a total of 1707 patients, 261 (15.3%) had E/A <0.6 and 124 (7.3%) had E/A>1.5. All cause death was higher with E/A <0.6 or E/A >1.5 compared to E/A 0.6-1.5 (25.7% and 16.9% versus 15.1%), as was vascular death (10.2% and 8.5% versus 5.8%). After adjusting for age, gender, previous stroke history, hypertension, diabetes, smoking, dyslipidemia, atrial fibrillation, stroke subtype, left ventricular end-diastolic diameter, LA/Ao ratio, mitral E deceleration time, relative wall motion abnormality, and initial stroke severities, the relative risk of all-cause death with E/A >1.5 was 2.24 (95% CI, 1.14-4.33; p= 0.02); the relative risk of vascular death with E/A>1.5 was 3.50 (95% CI, 1.39-8.80; p<0.01 ); the relative risk of stroke death with E/A >1.5 was 3.42 (95% CI, 1.21-9.69; p=0.02 ). Conclusion: The E/A>1.5 is associated with 2-fold increased all-cause mortality and 3-fold vascular and stroke mortalities independent of covariates in ischemic stroke patients.