TY - JOUR
T1 - Tissue Doppler index, E/E', and ischemic stroke in patients with atrial fibrillation and preserved left ventricular ejection fraction
AU - Lee, Sang Hak
AU - Choi, Seonghoon
AU - Chung, Wook Jin
AU - Byun, Young Sup
AU - Ryu, Sung Kee
AU - Pyun, Wook Bum
AU - Rim, Se Joong
PY - 2008/8/15
Y1 - 2008/8/15
N2 - Background: Although several risk factors for stroke have been reported in patients with atrial fibrillation (AF), the relation of LV diastolic dysfunction to stroke is still uncertain in these patients. We evaluated the relationship between tissue Doppler-derived index, E/E', as well as other clinical and echocardiographic parameters and ischemic stroke by this cross-sectional study. Methods: Three hundred thirty patients with persistent AF who had preserved LV ejection fraction were included from 6 centers. Clinical data were obtained and standard transthoracic echocardiography was performed. Patients without a history of ischemic stroke (n = 280) were compared with patients with this complication (n = 50). Potential determinants of ischemic stroke were identified by logistic regression analyses. Results: In univariate analyses, age, history of hypertension, diabetes mellitus, hyperlipidemia and symptomatic heart failure, plasma brain natriuretic peptide (BNP) level, early mitral inflow velocity (E), diastolic mitral annular velocity (E'), and E/E' ratio were significantly correlated to ischemic stroke. Multivariate regression analyses identified two significant variables that were independently associated with ischemic stroke: hypertension (odds ratio = 6.03, p = 0.008), and E/E' (odds ratio = 1.21, p = 0.002). Conclusions: These findings may have clinical implications that LV diastolic dysfunction, reflected by E/E', is a significant determinant of ischemic stroke in AF. A larger prospective data is needed to confirm the value of E/E' in risk stratification for ischemic stroke in this population.
AB - Background: Although several risk factors for stroke have been reported in patients with atrial fibrillation (AF), the relation of LV diastolic dysfunction to stroke is still uncertain in these patients. We evaluated the relationship between tissue Doppler-derived index, E/E', as well as other clinical and echocardiographic parameters and ischemic stroke by this cross-sectional study. Methods: Three hundred thirty patients with persistent AF who had preserved LV ejection fraction were included from 6 centers. Clinical data were obtained and standard transthoracic echocardiography was performed. Patients without a history of ischemic stroke (n = 280) were compared with patients with this complication (n = 50). Potential determinants of ischemic stroke were identified by logistic regression analyses. Results: In univariate analyses, age, history of hypertension, diabetes mellitus, hyperlipidemia and symptomatic heart failure, plasma brain natriuretic peptide (BNP) level, early mitral inflow velocity (E), diastolic mitral annular velocity (E'), and E/E' ratio were significantly correlated to ischemic stroke. Multivariate regression analyses identified two significant variables that were independently associated with ischemic stroke: hypertension (odds ratio = 6.03, p = 0.008), and E/E' (odds ratio = 1.21, p = 0.002). Conclusions: These findings may have clinical implications that LV diastolic dysfunction, reflected by E/E', is a significant determinant of ischemic stroke in AF. A larger prospective data is needed to confirm the value of E/E' in risk stratification for ischemic stroke in this population.
KW - Atrial fibrillation
KW - Cerebrovascular accident
KW - Diastole
KW - Doppler echocardiography
KW - Echocardiography
KW - Heart failure
KW - Ventricular function
UR - http://www.scopus.com/inward/record.url?scp=45849087655&partnerID=8YFLogxK
U2 - 10.1016/j.jns.2008.04.006
DO - 10.1016/j.jns.2008.04.006
M3 - Article
C2 - 18501379
AN - SCOPUS:45849087655
SN - 0022-510X
VL - 271
SP - 148
EP - 152
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
IS - 1-2
ER -