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Left ventricular systolic dysfunction and the risk of ischemic stroke in a multiethnic population.
Stroke 2006; 37(7):1715-9S

Abstract

BACKGROUND AND PURPOSE

Left ventricular dysfunction (LVD) is associated with cardiovascular mortality. Its association with ischemic stroke has been mainly documented after myocardial infarction. The stroke risk associated with LVD, especially of mild degree, in the general population is unclear. The purpose of this study was to evaluate the relationship between LVD and ischemic stroke in a multiethnic cohort.

METHODS

LV systolic function was assessed by transthoracic 2-dimensional echocardiography in a subset of subjects from the Northern Manhattan Study (NOMAS), 270 patients with first ischemic stroke and 288 age-, gender- and race-matched community controls. LV ejection fraction was measured by a simplified cylinder-hemiellipsoid formula, and categorized as normal (>50%), mildly (41% to 50%), moderately (31% to 40%) or severely (< or =30%) decreased. The association between impaired ejection fraction and ischemic stroke was evaluated by logistic regression analysis after adjustment for established stroke risk factors.

RESULTS

LVD of any degree was more frequent in stroke patients (24.1%) than in controls (4.9%; P<0.0001), as was moderate/severe LVD (13.3% versus 2.4%; P<0.001). A decreased ejection fraction was associated with ischemic stroke even after adjusting for other stroke risk factors. The adjusted odds ratio for any degree of LVD was 3.92 (95% CI, 1.93 to 7.97). The adjusted odds ratio for mild LVD was 3.96 (95% CI, 1.56 to 10.01) and for moderate/severe LVD 3.88 (95% CI, 1.45 to 10.39). The association between LVD of any degree and stroke was present in all age, gender and race-ethnicity subgroups.

CONCLUSIONS

LVD, even of mild degree, is independently associated with an increased risk of ischemic stroke. The assessment of LV function should be considered in the assessment of the stroke risk.

Authors+Show Affiliations

Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16741172

Citation

Hays, Allison G., et al. "Left Ventricular Systolic Dysfunction and the Risk of Ischemic Stroke in a Multiethnic Population." Stroke, vol. 37, no. 7, 2006, pp. 1715-9.
Hays AG, Sacco RL, Rundek T, et al. Left ventricular systolic dysfunction and the risk of ischemic stroke in a multiethnic population. Stroke. 2006;37(7):1715-9.
Hays, A. G., Sacco, R. L., Rundek, T., Sciacca, R. R., Jin, Z., Liu, R., ... Di Tullio, M. R. (2006). Left ventricular systolic dysfunction and the risk of ischemic stroke in a multiethnic population. Stroke, 37(7), pp. 1715-9.
Hays AG, et al. Left Ventricular Systolic Dysfunction and the Risk of Ischemic Stroke in a Multiethnic Population. Stroke. 2006;37(7):1715-9. PubMed PMID: 16741172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Left ventricular systolic dysfunction and the risk of ischemic stroke in a multiethnic population. AU - Hays,Allison G, AU - Sacco,Ralph L, AU - Rundek,Tanja, AU - Sciacca,Robert R, AU - Jin,Zhezhen, AU - Liu,Rui, AU - Homma,Shunichi, AU - Di Tullio,Marco R, Y1 - 2006/06/01/ PY - 2006/6/3/pubmed PY - 2006/7/19/medline PY - 2006/6/3/entrez SP - 1715 EP - 9 JF - Stroke JO - Stroke VL - 37 IS - 7 N2 - BACKGROUND AND PURPOSE: Left ventricular dysfunction (LVD) is associated with cardiovascular mortality. Its association with ischemic stroke has been mainly documented after myocardial infarction. The stroke risk associated with LVD, especially of mild degree, in the general population is unclear. The purpose of this study was to evaluate the relationship between LVD and ischemic stroke in a multiethnic cohort. METHODS: LV systolic function was assessed by transthoracic 2-dimensional echocardiography in a subset of subjects from the Northern Manhattan Study (NOMAS), 270 patients with first ischemic stroke and 288 age-, gender- and race-matched community controls. LV ejection fraction was measured by a simplified cylinder-hemiellipsoid formula, and categorized as normal (>50%), mildly (41% to 50%), moderately (31% to 40%) or severely (< or =30%) decreased. The association between impaired ejection fraction and ischemic stroke was evaluated by logistic regression analysis after adjustment for established stroke risk factors. RESULTS: LVD of any degree was more frequent in stroke patients (24.1%) than in controls (4.9%; P<0.0001), as was moderate/severe LVD (13.3% versus 2.4%; P<0.001). A decreased ejection fraction was associated with ischemic stroke even after adjusting for other stroke risk factors. The adjusted odds ratio for any degree of LVD was 3.92 (95% CI, 1.93 to 7.97). The adjusted odds ratio for mild LVD was 3.96 (95% CI, 1.56 to 10.01) and for moderate/severe LVD 3.88 (95% CI, 1.45 to 10.39). The association between LVD of any degree and stroke was present in all age, gender and race-ethnicity subgroups. CONCLUSIONS: LVD, even of mild degree, is independently associated with an increased risk of ischemic stroke. The assessment of LV function should be considered in the assessment of the stroke risk. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/16741172/Left_ventricular_systolic_dysfunction_and_the_risk_of_ischemic_stroke_in_a_multiethnic_population_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.STR.0000227121.34717.40?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -