Diastolic global longitudinal strain and acute ischemic stroke: a hidden relationship?

There is a bidirectional interaction between acute ischemic stroke (AIS) and the cardiovascular system. This study aimed to investigate the relationship between diastolic global longitudinal strain (GLS) and AIS. The prospective case-control study included 80 patients diagnosed with AIS and 45 control patients. It is well known that vascular risk factors have a significant impact on global longitudinal strain (GLS). Therefore, the control group was selected from cardiology outpatient clinic patients with vascular risk profiles similar to those of stroke patients. GLS measurements on echocardiography within the first 72 h after stroke onset were recorded. Demographic, clinical, and laboratory findings at admission were evaluated for both the patient and control groups. GLS values were significantly lower in both the patient group (-15.41% ± 3.60) and the control group (-10.70% ± 2.55) compared to the lower limit of normal GLS values reported in the literature (GLS lower limit = -18%, respectively, t = 6.207, p < 0.001; t = 19.178, p < 0.001). The GLS values were significantly higher in the stroke group than the control group (respectively, (-15.41% ± 3.60; (-10.70% ± 2.55); t = -7,698, p < 0.001), while no significant difference was observed between the groups in terms of ejection fraction (EF) (t: -1.612, p: 0.11). Acute ischemic stroke was identified as an independent factor associated with increased GLS (B = 3.761; 95% CI: 1.995-5.527; p < 0.001), and higher GLS values were found to be independent predictors of mildly to moderately better clinical outcomes, as measured by the modified Rankin Scale (F = 4.074; p: 0.047) in patients with acute ischemic stroke. These findings suggest that increased GLS may shed light on compensatory mechanisms aimed at preserving the penumbra in patients with acute ischemic stroke.