Evidence of subtle left ventricular systolic dysfunction in cryptogenic stroke in the young.
echocardiography
ischemic stroke
strain
strain rate imaging
three-dimensional echocardiography
Journal
Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
13
10
2020
revised:
30
11
2020
accepted:
30
12
2020
pubmed:
24
1
2021
medline:
9
7
2021
entrez:
23
1
2021
Statut:
ppublish
Résumé
Ischemic stroke in young patients often remains cryptogenic, that is, no underlying reason can be found. Some of these strokes may originate in the heart. Left ventricular (LV) dynamic volumetry and strain analysis are relatively new and promising methods for evaluating LV function. In this pilot study, we recruited 30 young (18-50 years) patients with cryptogenic ischemic stroke and 30 age- and sex-matched controls from the SECRETO study (NCT01934725). The LV systolic function was assessed by LV volumetry (ejection fraction, peak emptying rate, and time to peak emptying rate). The longitudinal systolic function was assessed by speckle tracking strain and strain rate imaging, and by tissue velocity imaging derived MAD (mitral annular displacement) and septal S'. Stroke patients had less vigorous global longitudinal strain (median -18.9, interquartile range 3.3), compared to healthy controls (median -20.0, interquartile range 2.8), P = .010. There was no statistically significant differences in septal S', MAD, global longitudinal strain rate, or dynamic volumetry-derived parameters between the two groups. Young cryptogenic stroke patients have subtly altered systolic function compared to healthy controls, found merely with longitudinal strain analysis. This infers that the heart may play a role in the pathogenesis of cryptogenic ischemic stroke.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
271-279Informations de copyright
© 2021 The Authors. Echocardiography published by Wiley Periodicals LLC.
Références
Putaala J, Yesilot N, Waje-Andreassen U, et al. Etiology of first-ever ischaemic stroke in European young adults: the 15 cities young stroke study. Stroke. 2012;43:2624-2630.
Nakayama R, Takaya Y, Akagi T, et al. Identification of high-risk patent foramen ovale associated with cryptogenic stroke: development of a scoring system. J Am Soc Echocardiogr. 2019;32:811-816.
Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233-270.
Matos J, Kronzon I, Panagopoulos G, et al. Mitral annular plane systolic excursion as a surrogate for left ventricular ejection fraction. J Am Soc Echocardiogr. 2012;25:969-974.
Dunkman WB, Johnson GR, Carson PE, et al. Incidence of thromboembolic events in congestive heart failure. The V-HeFT VA Cooperative Studies Group. Circulation. 1993;87(6 Suppl):VI94-101.
Freudenberger RS, Cheng B, Mann DL, et al. WARCEF Investigators. The first prognostic model for stroke and death in patients with systolic heart failure. J Cardiol. 2016;68:100-103.
Putaala J, Martinez-Majander N, Saeed S, et al. Searching for explanations for cryptogenic stroke in the young: revealing the triggers, causes, and outcome (SECRETO): rationale and design. Eur Stroke J. 2017;2:116-125.
Saeed S, Gerdts E, Waje-Andreassen U, et al. Searching for explanations for cryptogenic stroke in the young: revealing the etiology, triggers, and outcome (SECRETO): echocardiography performance protocol. Echo Res Pract. 2019;6:53-61.
Pirinen J, Järvinen V, Martinez-Majander N, et al. Left atrial dynamics is altered in young adults with cryptogenic ischemic stroke: a case-control study utilizing advanced echocardiography. J Am Heart Assoc. 2020;9:e014578.
de Knegt MC, Biering-Sorensen T, Sogaard P, et al. Concordance and reproducibility between M-mode, tissue Doppler imaging, and two-dimensional strain imaging in the assessment of mitral annular displacement and velocity in patients with various heart conditions. Eur Heart J Cardiovasc Imaging. 2014;15:62-69.
Galderisi M, Henein MY, D'hooge J, et al. Recommendations of the European Association of Echocardiography: how to use echo-Doppler in clinical trials: different modalities for different purposes. Eur J Echocardiogr. 2011;12:339-353.
Biering-Sørensen T, Biering-Sørensen SR, Olsen FJ, et al. Global longitudinal strain by echocardiography predicts long-term risk of cardiovascular morbidity and mortality in a low-risk general population: the copenhagen city heart study. Circ Cardiovasc Imaging. 2017;10:e005521.
Saeed S, Gerdts E, Waje-Andreassen U, et al. Left ventricular myocardial dysfunction in young and middle-aged ischemic stroke patients: the Norwegian stroke in the young study. J Hypertens. 2019;37:538-545.
Sawada N, Nakanishi K, Daimon M, et al. Influence of visceral adiposity accumulation on adverse left and right ventricular mechanics in the community. Eur J Prev Cardiol. 2019;3:2047487319891286.
Ermis E, Demirelli S, Ceylan M, et al. The evaluation of myocardial function of patients in the early stage of acute ischemic stroke by two-dimensional speckle tracking echocardiography. J Clin Ultrasound. 2016;44:305-311.
Zamorano JL, Lancellotti P, Rodriguez Muñoz D, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J. 2016;37:2768-2801.
Kalaycı A, Karabay CY, Kocabay G. Subclinical left ventricular dysfunction in chronic asymptomatic alcoholic patients. Koşuyolu Heart Journal. 2016;19:154-160.
Hieda M, Parker J, Rajabi T, et al. Left ventricular volume-time relation in patients with heart failure with preserved ejection fraction. Am J Cardiol. 2018;121:609-614.
Pirinen J, Kuusisto J, Järvinen V, et al. Diastolic function in young patients with cryptogenic stroke: a case-control pilot study. Clin Physiol Funct Imaging. 2020;40:336-342.
Saha S, Nowak J, Storaa C, et al. MYDISE investigators. Functional diagnosis of coronary stenosis using tissue tracking provides best sensitivity and specificity for left circumflex disease: experience from the MYDISE (myocardial Doppler in stress echocardiography) study. Eur J Echocardiogr. 2005;6:54-63.
Mädler CF, Payne N, Wilkenshoff U, et al. Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography: optimal diagnostic models using off-line tissue Doppler in the MYDISE study. Eur Heart J. 2003;24:1584-1594.