Abstract
ObjectivesThe relationship between cerebral ischemic stroke and left ventricular function evaluated by echocardiography has been emphasized. Whether lesions in different cerebral artery regions would result in left ventricular dysfunction remains uncertain.MethodsPatients were divided into middle cerebral artery (MCA) (n = 79), posterior cerebral artery (PCA) (n = 64), basilar artery (BA) regions (n = 66), and no-ischemic stroke group (n = 209). We retrospectively collected demographic characteristics, hematologic parameters, and ECG results, and a comparison of echocardiographic parameters was performed to determine the relationship between ischemic stroke and left ventricular function.ResultsA total of 418 patients were included. Demographic characteristics did not significantly differ between the ischemic stroke and non-ischemic stroke groups, except for a history of drinking (p < 0.001). Homocysteine levels in the MCA group were higher than those in the PCA and BA groups (p < 0.05). The highly sensitive C-reactive protein (hs-CRP) level was higher in the ischemic stroke group than in the non-ischemic stroke one (p = 0.001). A higher incidence of ST-T changes in the ECG and lower levels of potassium and magnesium in the ischemic stroke group were found. Significant differences in diastolic function between groups were noted, and the early mitral inflow velocity, annular early diastolic velocity, and ratio between the mitral annular early diastolic velocity and mitral annulus atrial inflow velocity in the MCA group were lower than those in the BA group (p < 0.05).ConclusionsIschemic strokes exhibited a negative effect on left ventricular diastolic function by echocardiography, especially in MCA region infarcts. These results are of great importance for neurologists as they highlight the need for left ventricular function evaluation after stroke to regulate therapy strategies in time.
Highlights
Over the past 10 years, the increased incidence of cerebral ischemic strokes has been attributed to behavioral, metabolic, and environmental factors [1]
A total of 418 patients were included in the study, 209 of whom were in the ischemic stroke group based on the brain MRI and clinical diagnosis
These patients were further subdivided into middle cerebral artery (MCA) (n = 79), the posterior cerebral artery (PCA) (n = 64), and basilar artery (BA) (n = 66) groups based on the location of the infarct (Figures 2, 3)
Summary
Over the past 10 years, the increased incidence of cerebral ischemic strokes has been attributed to behavioral, metabolic, and environmental factors [1]. More than 1.5 million people die of post-stroke cardiovascular complications worldwide annually, such as myocardial infarction, unstable angina, congestive heart failure, and coronary artery diseases [2]. The cardiac complications of strokes are dependent on their locations. Strokes of the insular lobe and basal ganglia, located in the middle cerebral artery (MCA) region, can lead to the loss of cardiac rhythm control, variability to fatal arrhythmias, and death [5, 6]. Thalamic strokes, located in the posterior cerebral artery (PCA) region, can cause disturbance of the autonomic nervous system in Takotsubo cardiomyopathy [7]. The nucleus ambiguous and nucleus dorsalis, located in the basilar artery (BA) region, convey parasympathetic modulation of the central cardiovascular system [8]. In the event of a stroke, the balance between parasympathetic and sympathetic modulation is disrupted, leading to the coronary artery spasm and myocardial ischemia [9]
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