Cardiac function and outcome in patients with cardio-embolic stroke
- Authors
- Byun, J.-I.; Jung, K.-H.; Kim, Y.-D.; Kim, J.-M.; Roh, J.-K.
- Issue Date
- Apr-2014
- Publisher
- Public Library of Science
- Citation
- PLoS ONE, v.9, no.4
- Journal Title
- PLoS ONE
- Volume
- 9
- Number
- 4
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/13890
- DOI
- 10.1371/journal.pone.0095277
- ISSN
- 1932-6203
- Abstract
- Background: The relationship between whole spectrum of Ejection fraction (EF) and cardioembolic stroke (CES) outcome has not been fully described yet. Notably, it remains unclear whether borderline EF (41-49%) is related with poor outcome after CES. We sought to evaluate whether lower ejection fraction and borderline EF could predict the outcome in patients with CES. Method and Results: We evaluated the relationship between EF and functional outcome in 437 consecutive patients with CES. EF was introduced as continuous and categorical (EF≤40%, EF 41-49%, EF≥50%) variable. Patients with CES and the subgroup with AF were evaluated separately. Poor short-term outcome (modified Rankin Score≥3at discharge or death within 90 days after stroke onset) and long-term mortality were evaluated. A total of 165 patients (37.8%) had poor shortterm outcomes. EF tends to be lower in patients with poor short-term outcome (56.8±11.0 vs. 54.8±12.0, p-value 0.086). Overall cumulative death was136 (31.1%) in all CES patients and 106 (31.7%) in the AF subgroup. In a multivariable model adjusted for possible covariates, the hazard ratio for mortality significantly decreased by 3% for every 1% increase in ejection fraction in CES patients and 2% for every 1% increase in the AF subgroup. Reduced EF (EF≤40%) showed higher mortality (HR 2.61), and those with borderline EF (41-49%) had a tendency of higher mortality (HR 1.65, p-value 0.067)compared with those with normal EF. Conclusion: We found a strong association between lower EF and CES outcome. Echocardiographic evaluation helps to better determine the prognosis in CES patients, even in subgroup of patients with AF. © 2014 Byun et al.
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