Clinical Neurosciences Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Neurology Unit, Neuroscience Department A.S.S.T. Lecco, Merate Hospital, 23807 Merate, Italy.
Medicina (Kaunas). 2024 Oct 16;60(10):1699. doi: 10.3390/medicina60101699.
Stroke-heart syndrome (SHS), a critical yet underrecognized condition, encompasses a range of cardiac complications that arise following an ischemic stroke. This narrative review explores the pathophysiology, clinical manifestations, and implications of SHS, focusing on the complex interplay between the brain and the heart. Acute ischemic stroke (AIS) triggers autonomic dysfunction, leading to a surge in catecholamines and subsequent myocardial injury. Our review highlights the five cardinal manifestations of SHS: elevated cardiac troponin (cTn) levels, acute myocardial infarction, left ventricular dysfunction, arrhythmias, and sudden cardiac death. Despite the significant impact of these complications on patient outcomes, there is a notable absence of specific guidelines for their management. Through a comprehensive literature search, we synthesized findings from recent studies to elucidate the mechanisms underlying SHS and identified gaps in the current understanding. Our findings underscore the importance of early detection and multidisciplinary management of cardiac complications post-stroke. Future research should focus on establishing evidence-based protocols to improve clinical outcomes for stroke patients with SHS. Addressing this unmet need will enhance the care of stroke survivors and reduce mortality rates associated with cardiac complications.
中风-心脏综合征(SHS)是一种严重但认识不足的病症,涵盖了一系列在缺血性中风后出现的心脏并发症。本综述探讨了 SHS 的病理生理学、临床表现和意义,重点关注了大脑和心脏之间的复杂相互作用。急性缺血性中风(AIS)引发自主神经功能障碍,导致儿茶酚胺激增,进而引发心肌损伤。我们的综述强调了 SHS 的五个主要表现:心肌肌钙蛋白(cTn)水平升高、急性心肌梗死、左心室功能障碍、心律失常和心源性猝死。尽管这些并发症对患者预后有重大影响,但针对其管理尚无专门的指南。通过全面的文献检索,我们综合了近期研究的结果,阐明了 SHS 的发病机制,并指出了目前认识中的空白。我们的研究结果强调了早期发现和多学科管理中风后心脏并发症的重要性。未来的研究应致力于制定基于证据的方案,以改善患有 SHS 的中风患者的临床结局。满足这一未满足的需求将改善中风幸存者的护理并降低与心脏并发症相关的死亡率。