Department of Neurology, University of Health Sciences, Diyarbakır Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.
Department of Cardiology, University of Health Sciences, Diyarbakır Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.
Neurol India. 2023 Sep-Oct;71(5):933-939. doi: 10.4103/0028-3886.388123.
Acute stroke is an important cause of morbidity and mortality. Myocardial injury is an important complication of acute cerebrovascular events. Neurogenic stress cardiomyopathy (NSC) is a condition of acute myocardial systolic dysfunction that can be observed after acute cerebrovascular events.
In this study, we aimed to investigate the relationship between myocardial function assessed by two-dimensional speckle-tracking echocardiography and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke.
This cross-sectional study screened 97 patients (males, 42; females, 55; 65 ± 16 years) with acute ischemic stroke. Around 17 patients were excluded and 80 patients were studied. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score <16; Group 2, NIHSS score ≥16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by two-dimensional speckle tracking echocardiography within 48 h of admission to the neurology care unit.
There were no significant differences in the demographic parameters of patients. The absolute value of global longitudinal systolic strain (GLS) was significantly higher in Group 1 patients than in Group 2 patients (21.4 ± 2.2 vs 15.9 ± 2.7, P = 0.0281). We found that thirteen patients (22%) had normal LVEF and abnormal LV GLS in Group 1 (P = 0.036). Eight patients (36%) had normal LVEF and abnormal LV GLS in Group 2 (P = 0.042). E/e', QT on ECG, and serum troponin levels were significantly higher in Group 2 patients than in Group 1 patients (P < 0.05).
Our results suggest that GLS is associated with stroke severity on admission in patients with acute ischemic stroke. GLS is an indicator of myocardial deformation with a different from LVEF. GLS can detect early myocardial dysfunction despite preserved LVEF.
急性脑卒中是发病率和死亡率的重要原因。心肌损伤是急性脑血管事件的重要并发症。神经原性应激性心肌病(NSC)是一种急性心肌收缩功能障碍的情况,可在急性脑血管事件后观察到。
本研究旨在探讨二维斑点追踪超声心动图评估的心肌功能与急性缺血性脑卒中患者国立卫生研究院卒中量表(NIHSS)评分之间的关系。
本横断面研究筛选了 97 例急性缺血性脑卒中患者(男性 42 例,女性 55 例;65±16 岁)。排除了约 17 例患者,共 80 例患者进行了研究。根据计算出的 NIHSS 评分,将患者分为两组(NIHSS 评分<16 分,组 1;NIHSS 评分≥16 分,组 2)。收集所有患者的人口统计学、临床和实验室数据。在神经内科护理单元入院后 48 小时内通过二维斑点追踪超声心动图评估心功能。
患者的人口统计学参数无显著差异。组 1 患者的整体纵向收缩应变(GLS)绝对值明显高于组 2 患者(21.4±2.2 比 15.9±2.7,P=0.0281)。我们发现组 1 中有 13 例(22%)患者的左室射血分数(LVEF)正常但左室 GLS 异常(P=0.036)。组 2 中有 8 例(36%)患者的 LVEF 正常但左室 GLS 异常(P=0.042)。组 2 患者的 E/e'、心电图 QT 间期和血清肌钙蛋白水平明显高于组 1 患者(P<0.05)。
我们的研究结果表明,急性缺血性脑卒中患者入院时 GLS 与卒中严重程度相关。GLS 是一种与 LVEF 不同的心肌变形指标。GLS 可以在保留 LVEF 的情况下检测到早期心肌功能障碍。