Ozkan Melis, Tatar Sefa, Tokgöz Osman Serhat
Department of Neurology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
Department of Cardiology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
BMC Cardiovasc Disord. 2025 May 19;25(1):383. doi: 10.1186/s12872-025-04841-2.
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.
急性缺血性卒中（AIS）与心血管系统之间存在双向相互作用。本研究旨在探讨舒张期整体纵向应变（GLS）与AIS之间的关系。这项前瞻性病例对照研究纳入了80例确诊为AIS的患者和45例对照患者。众所周知，血管危险因素对整体纵向应变（GLS）有显著影响。因此，对照组选自心血管门诊中具有与卒中患者相似血管风险特征的患者。记录卒中发作后72小时内超声心动图测量的GLS值。对患者组和对照组入院时的人口统计学、临床和实验室检查结果进行评估。与文献报道的正常GLS值下限相比，患者组（-15.41%±3.60）和对照组（-10.70%±2.55）的GLS值均显著降低（GLS下限分别为-18%，t=6.207，p<0.001；t=19.178，p<0.001）。卒中组的GLS值显著高于对照组（分别为（-15.41%±3.60；（-10.70%±2.55）；t=-7,698，p<0.001），而两组间射血分数（EF）无显著差异（t：-1.612，p：0.11）。急性缺血性卒中被确定为与GLS升高相关的独立因素（B=3.761；95%CI：1.995-5.527；p<0.001），并且发现较高的GLS值是急性缺血性卒中患者临床结局轻度至中度改善的独立预测因素，采用改良Rankin量表测量（F=4.074；p：0.047）。这些发现表明，GLS升高可能有助于揭示急性缺血性卒中患者旨在保护半暗带的代偿机制。
