Higher Left Ventricle Mass Indices Predict Favorable Outcome in Stroke Patients with Thrombolysis

J Stroke Cerebrovasc Dis. 2015 Jul;24(7):1609-13. doi: 10.1016/j.jstrokecerebrovasdis.2015.03.034. Epub 2015 May 7.

Abstract

Background: We sought to assess the association of left ventricle mass (LVM) indices with the functional outcome of acute ischemic stroke (AIS) patients after intravenous tissue plasminogen activator (IV-tPA).

Methods: Consecutive AIS patients with IV-tPA were recruited. LVM indices including LVM/weight, LVM/surface, and LVM/heightˆ(2.7) on echocardiogram during hospitalization were retrospectively reviewed. Outcome was 90-day modified Rankin scale (mRS) scores. Multivariate logistic regression was performed to analyze the association of LVM indices with outcome.

Results: Between August 2010 and May 2014, 55 AIS patients (age range from 27 to 78 years, 69.1% men) with echocardiogram after thrombolysis were recruited. Lower baseline National Institutes of Health Stroke Scale (NIHSS; P = .009) and higher LVM indices (LVM/weight [P = .012], LVM/surface [P = .039], and LVM/heightˆ(2.7) [P = .045]) were significantly associated with 90-day favorable outcome (mRS, 0-2). In multivariate logistic regression analysis, LVM/weight independently predicted good outcome with an odds ratio of 3.89 (95% confidence interval, 1.05-14.42, P = .042) after adjustment for baseline NIHSS, onset-to-treatment time, hypertension, hemorrhagic transformation, and systolic left ventricle inner diameters.

Conclusions: Higher LVM indices on echocardiogram are significantly associated with favorable outcome in stroke patients with IV-tPA, among which LVM/weight seems to be the most effective.

Keywords: Echocardiogram; left ventricle mass; stroke outcome; thrombolysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cerebral Angiography / methods
  • Disability Evaluation
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Fibrinolytic Agents / adverse effects
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Hypertrophy, Left Ventricular / physiopathology
  • Infusions, Intravenous
  • Logistic Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Recovery of Function
  • Retrospective Studies
  • Risk Factors
  • Stroke / complications
  • Stroke / diagnosis
  • Stroke / drug therapy*
  • Stroke / physiopathology
  • Thrombolytic Therapy* / adverse effects
  • Time Factors
  • Tissue Plasminogen Activator / administration & dosage*
  • Tissue Plasminogen Activator / adverse effects
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography
  • Ventricular Function, Left

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator