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急性缺血性卒中患者的心脏功能与短期预后:一项横断面研究

Cardiac Function and Short-Term Outcome in Patients with Acute Ischemic Stroke: A Cross-Sectional Study.

作者信息

Mathias Tiffany L, Albright Karen C, Boehme Amelia K, George Alexander J, Monlezun Dominique, Jones Erica, Beasley T Mark, Martin-Schild Sheryl

机构信息

Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112 (TLM, DM, AJG, EJ, SMS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (KCA, AKB); Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE) (KCA); Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC) (KCA); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35249 (TMB).

出版信息

J Cardiovasc Dis. 2013 Oct;1(2):26-29.

Abstract

Few studies have investigated the relationship between left ventricular ejection fraction (LVEF) and functional outcome in ischemic stroke patients. The purpose of this study was to determine if a low LVEF in ischemic stroke was associated with functional outcome. A cross-sectional study was performed on ischemic stroke patients admitted to a single academic stroke center from June 2008 to December 2010. LVEF was determined using transthoracic or transesophageal echocardiography. Patients were categorized into three LVEF groups: severely low (<30%), moderately low (30-49%), and normal (>50%). Baseline demographics, in-hospital complications, and early outcomes were compared among LVEF groups using Chi-square, Wilcoxon rank sum, and logistic regression.590 patients met inclusion criteria (median age 65, 74% African American, 48% female). LVEF was normal in 79.8%, moderately low in 10.8%, and severely low in 9.3%. A smaller proportion of patients with severely low LVEF appeared to have good functional outcome compared to other groups (26% vs. 40% vs. 45%, p=0.028); however, this relationship was not significant after adjusting for age, baseline National Institute of Health Stroke Scale score and admission glucose (OR 0.6, 95% CI 0.3-1.3, p=0.216). Low LVEF was not an independent, significant predictor of short-term functional outcomes in ischemic stroke patients.

摘要

很少有研究调查缺血性中风患者左心室射血分数(LVEF)与功能预后之间的关系。本研究的目的是确定缺血性中风患者的低LVEF是否与功能预后相关。对2008年6月至2010年12月入住单一学术性中风中心的缺血性中风患者进行了一项横断面研究。使用经胸或经食管超声心动图测定LVEF。患者被分为三个LVEF组:严重降低(<30%)、中度降低(30-49%)和正常(>50%)。使用卡方检验、Wilcoxon秩和检验和逻辑回归对LVEF组之间的基线人口统计学、住院并发症和早期预后进行比较。590名患者符合纳入标准(中位年龄65岁,74%为非裔美国人,48%为女性)。LVEF正常者占79.8%,中度降低者占10.8%,严重降低者占9.3%。与其他组相比,LVEF严重降低的患者中功能预后良好的比例较小(26%对40%对45%,p=0.028);然而,在调整年龄、基线美国国立卫生研究院卒中量表评分和入院血糖后,这种关系并不显著(OR 0.6,95%CI 0.3-1.3,p=0.216)。低LVEF不是缺血性中风患者短期功能预后的独立显著预测因素。

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