Bao Jie, Wang Chen, Zhang Yimeng, Su Zhuangzhi, Du Xiangying, Lu Jie
Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
Front Neurol. 2023 Jul 5;14:1173276. doi: 10.3389/fneur.2023.1173276. eCollection 2023.
The outcomes of patients with acute ischemic stroke (AIS) are related to cardiac function. Cardiac insufficiency can manifest as hydrostatic changes in the lungs. Computed tomography (CT) of the chest is commonly used for screening pulmonary abnormalities and provides an opportunity to assess cardiac function.
To evaluate the correlation between hydrostatic lung manifestations on chest CT and cardiac function with its potential to predict the short-term outcome of AIS patients.
We retrospectively analyzed AIS patients who had undergone chest CT at admission and echocardiogram within 48 h. Morphological and quantitative hydrostatic changes and left ventricular dimensions were assessed using chest CT. Improvement in the National Institutes of Health Stroke Scale (NIHSS) score on the seventh day determined short-term outcomes. Multivariate analysis examined the correspondence between hydrostatic lung manifestations, left ventricular dimension, and left ventricle ejection fraction (LVEF) on echocardiography, and the correlation between hydrostatic changes and short-term outcomes.
We included 204 patients from January to December 2021. With the progression of hydrostatic changes on chest CT, the LVEF on echocardiography gradually decreased ( < 0.05). Of the 204, 53 patients (26%) with varying degrees of hypostatic lung manifestations had less improvement in the NIHSS score ( < 0.05). The density ratio of the anterior/posterior lung on CT showed a significant negative correlation with improvement in the NIHSS score ( = -5.518, < 0.05). Additionally, patients with a baseline NIHSS ≥4 with left ventricular enlargement had significantly lower LVEF than that of patients with normal NIHSS scores.
Hydrostatic lung changes on chest CT can be used as an indicator of cardiac function and as a preliminary reference for short-term outcome in AIS patients.
急性缺血性卒中（AIS）患者的预后与心功能有关。心功能不全可表现为肺部的流体静力变化。胸部计算机断层扫描（CT）常用于筛查肺部异常，并提供评估心功能的机会。
评估胸部CT上的流体静力性肺表现与心功能之间的相关性及其预测AIS患者短期预后的潜力。
我们回顾性分析了入院时接受胸部CT检查并在48小时内接受超声心动图检查的AIS患者。使用胸部CT评估形态学和定量流体静力变化以及左心室尺寸。第7天美国国立卫生研究院卒中量表（NIHSS）评分的改善情况决定短期预后。多变量分析检查了超声心动图上流体静力性肺表现、左心室尺寸和左心室射血分数（LVEF）之间的对应关系，以及流体静力变化与短期预后之间的相关性。
我们纳入了2021年1月至12月的204例患者。随着胸部CT上流体静力变化的进展，超声心动图上的LVEF逐渐降低（P<0.05）。在这204例患者中，53例（26%）有不同程度的坠积性肺表现，其NIHSS评分改善较少（P<0.05）。CT上肺前后密度比与NIHSS评分的改善呈显著负相关（r=-5.518，P<0.05）。此外，基线NIHSS≥4且左心室扩大的患者的LVEF明显低于NIHSS评分正常的患者。
胸部CT上的流体静力性肺变化可作为心功能的指标，并作为AIS患者短期预后的初步参考。
