[1]左 鹏,倪小宇,徐长松,等.左心室射血分数对急性心源性前循环大血管闭塞性脑卒中血管内治疗预后的影响[J].介入放射学杂志,2022,31(12):1189-1193.
ZUO Peng,NI Xiaoyu,XU Changsong,et al.The effect of left ventricular ejection fraction on the prognosis of patients with acute cardiogenic anterior circulation large vessel occlusive stroke after receiving endovascular treatment[J].journal interventional radiology,2022,31(12):1189-1193.
点击复制
左心室射血分数对急性心源性前循环大血管闭塞性脑卒中血管内治疗预后的影响()
《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]
- 卷:
-
31
- 期数:
-
2022年12
- 页码:
-
1189-1193
- 栏目:
-
临床研究
- 出版日期:
-
2023-01-11
文章信息/Info
- Title:
-
The effect of left ventricular ejection fraction on the prognosis of patients with acute cardiogenic anterior circulation large vessel occlusive stroke after receiving endovascular treatment
- 作者:
-
左 鹏; 倪小宇; 徐长松; 吴 嶛; 倪贵华
-
- Author(s):
-
ZUO Peng; NI Xiaoyu; XU Changsong; WU Liao; NI Guihua.
-
Department of Neurology, Affiliated Huai’an Municipal First People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu Province 223300, China
-
- 关键词:
-
【关键词】 左心室射血分数; 心源性脑卒中; 血管内治疗; 预后因素
- 文献标志码:
-
A
- 摘要:
-
【摘要】 目的 探讨左心室射血分数(LVEF)对急性心源性前循环大血管闭塞性脑卒中患者血管内治疗预后的影响。方法 回顾性分析自2019年1月至2021年1月南京医科大学附属淮安第一医院采用血管内介入术治疗的78例急性心源性前循环大血管闭塞性脑卒中患者超声心动图数据。定义LVEF≥50%为正常值,<50%为下降值。术后3个月采用改良Rankin量表(mRS)评分评估患者预后,0~2分为预后良好,3~6分为预后不良。采用多因素logistic回归分析判断预后影响因素。结果 术后预后良好44例(56.4%),预后不良34例(43.6%)。预后良好组与预后不良组相比,LVEF下降(9.1%比26.5%,P=0.041)、左心室舒张功能减低(29.5%比52.9%,P=0.036)差异均有统计学意义。多因素logistic 回归分析结果显示,LVEF下降(OR=0.195,P=0.032)、入院时美国国立卫生研究院卒中量表(NIHSS)评分(OR=0.889,P=0.030)、伴糖尿病(OR=0.217,P=0.014)和颈内动脉末端闭塞(OR=0.278,P=0.028)是急性心源性前循环大血管闭塞性脑卒中患者血管内治疗术后良好预后的独立危险因素。结论 急性心源性前循环大血管闭塞性脑卒中患者血管内治疗后LVEF(<50%)下降,临床预后较差。
参考文献/References:
[1] Tiedt S, Herzberg M, Küpper C, et al. Stroke etiology modifies the effect of endovascular treatment in acute stroke[J]. Stroke, 2020, 51: 1014-1016.
[2] Khan MN, Usmani A, Noor S, et al. Low incidence of left atrial or left atrial appendage thrombus in patients with paroxysmal atrial fibrillation and normal EF who present for pulmonary vein antrum isolation procedure[J]. J Cardiovasc Electrophysiol, 2008, 19: 356-358.
[3] Kim M, Kim HL, Park KT, et al. Echocardiographic parameters determining cardiovascular outcomes in patients after acute ischemic stroke[J]. Int J Cardiovasc Imaging, 2020, 36: 1445-1454.
[4] Battaglini D, Robba C, Lopes Da Silva A, et al. Brain-heart interaction after acute ischemic stroke[J]. Crit Care, 2020, 24: 163.
[5] Chen BJ, Daneshvari NO, Johansen MC. Bleeding risk in patients with cardiac disease from ischaemic stroke reperfusion therapy: an update[J]. BMJ Neurol Open, 2021, 3: e000156.
[6] Tan BYQ, Leow AS, Lee TH, et al. Left ventricular systolic dysfunction is associated with poor functional outcomes after endovascular thrombectomy[J]. J Neurointerv Surg, 2021, 13: 515-518.
[7] Zotter M,Piechowiak EI,Balasubramaniam R,et al. Endovascular therapy in patients with large vessel occlusion due to cardio-embolism versus large- artery atherosclerosis[J]. Ther Adv Neurol Disord, 2021, 14: 1756286421999017.
[8] 孟飞龙,徐浩文,权 涛,等. 急性颅内大血管闭塞机械再通患者预后影响因素分析[J]. 介入放射学杂志, 2020, 29:1177-1181.
[9] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志, 2018, 46:760-789.
[10] Byun JI,Jung KH, Kim YD,et al. Cardiac function and outcome in patients with cardio-embolic stroke[J]. PLoS One, 2014, 9: e95277.
[11] Burkot J, Kopec G, Pera J, et al. Decompensated heart failure is a strong Independent predictor of functional outcome after ischemic stroke[J]. J Card Fail, 2015, 21: 642-646.
[12] Milionis H, Faouzi M, Cordier M, et al. Characteristics and early and long-term outcome in patients with acute ischemic stroke and low ejection fraction[J]. Int J Cardiol, 2013, 168: 1082-1087.
[13] Uzieblo- Zyczkowska B,Krzesinski P,Jurek A,et al. Left ventricular ejection fraction is associated with the risk of thrombus in the left atrial appendage in patients with atrial fibrillation[J]. Cardiovasc Ther, 2020,2020: 3501749.
[14] Lin HB,Li FX,Zhang JY,et al. Cerebral- cardiac syndrome and diabetes: cardiac damage after ischemic stroke in diabetic state[J]. Front Immunol, 2021, 12: 737170.
[15] Li Y, Fitzgibbons TP,Mcmanus DD,et al. Left ventricular ejection fraction and clinically defined heart failure to predict 90- day functional outcome after ischemic stroke[J]. J Stroke Cerebrovasc Dis, 2019, 28: 371-380.
[16] Siedler G, Sommer K, Macha K, et al. Heart failure in ischemic stroke: relevance for acute care and outcome[J]. Stroke, 2019, 50: 3051-3056.
[17] Abdul-Rahim AH, Fulton RL, Frank B, et al. Associations of chronic heart failure with outcome in acute ischaemic stroke patients who received systemic thrombolysis: analysis from VISTA[J]. Eur J Neurol, 2015, 22: 163-169.
备注/Memo
- 备注/Memo:
-
(收稿日期:2022-01-24)
(本文编辑:边 佶)
更新日期/Last Update:
2023-01-11