Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study. Academic Article uri icon

Overview

abstract

  • Recent evidence indicates that our understanding of the relationship between cardiac function and ischemic stroke remains incomplete. The Cardiovascular Health Study enrolled community-dwelling adults ≥ 65 years old. We included participants with speckle-tracking data from digitized baseline study echocardiograms. Exposures were left atrial reservoir strain (primary), left ventricular longitudinal strain, left ventricular early diastolic strain rate, septal e' velocity, and lateral e' velocity. The primary outcome was incident ischemic stroke. Cox proportional hazards models were adjusted for demographics, image quality, and risk factors including left ventricular ejection fraction and incident atrial fibrillation. Among 4,000 participants in our analysis, lower (worse) left atrial reservoir strain was associated with incident ischemic stroke (HR per SD absolute decrease, 1.14; 95% CI 1.04-25). All secondary exposure variables were significantly associated with the outcome. Left atrial reservoir strain was associated with cardioembolic stroke (HR per SD absolute decrease, 1.42; 95% CI 1.21-1.67) and cardioembolic stroke related to incident atrial fibrillation (HR per SD absolute decrease, 1.60; 1.32-1.95). Myocardial dysfunction that can ultimately lead to stroke may be identifiable at an early stage. This highlights opportunities to identify cerebrovascular risk earlier and improve stroke prevention via therapies for early myocardial dysfunction.

publication date

  • August 30, 2021

Research

keywords

  • Brain Ischemia
  • Ischemic Stroke
  • Stroke Volume
  • Ventricular Function, Left

Identity

PubMed Central ID

  • PMC8405795

Scopus Document Identifier

  • 85113869280

Digital Object Identifier (DOI)

  • 10.1161/CIRCULATIONAHA.115.017719

PubMed ID

  • 34462469

Additional Document Info

volume

  • 11

issue

  • 1