Cardiac Function and Outcome in Patients with Cardio-Embolic StrokeReport as inadecuate




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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 0.067compared 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.



Author: Jung-Ick Byun, Keun-Hwa Jung , Young-Dae Kim, Jeong-Min Kim, Jae-Kyu Roh

Source: http://plos.srce.hr/



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