A Novel Approach to Assessing the Severity of Acute Stroke and Neurological Deficits in Patients with Acute Ischemic Stroke Using Myocardial Work Echocardiography

Overview

Journal Anatol J Cardiol

Publisher Kare Publishing

Specialty Cardiology & Vascular Diseases

Date 2022 Aug 11

PMID 35949122

Authors

Jun Zhang

Xu-Chu Wu

Xiao-Zhi Zheng

Affiliations

Soon will be listed here.

Abstract

Background: We aimed to evaluate the feasibility and performance of myocardial work echocardiography in assessing the severity of acute stroke and neurological deficits in patients with acute ischemic stroke.

Methods: A total of 176 patients were examined by echocardiography within 24-48 hours of symptom onset with the measurement of global and regional myocardial work. The National Institutes of Health Stroke Scale score of each patient was documented.

Results: With the increase of the National Institutes of Health Stroke Scale score, myocardial constructive work or positive work decreased (P 15 or not. The optimal cutoff value was 3.89, with a sensitivity of 100%, a specificity of 93.0%, a positive predictive value of 84.9%, a negative predictive value of 100%, and an accuracy of 95.7%.

Conclusion: Noninvasive myocardial work is highly competent in assessing the severity of acute stroke and neurological deficits, which can be used as a powerful supplement to the conventional scoring system.

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References

Zheng X, Ji P, Mao H, Hu J . Reduced antegrade flow in the coronary sinus is a predictor of coronary artery stenosis in hypertensive patients. J Ultrasound Med. 2012; 31(1):7-14. DOI: 10.7863/jum.2012.31.1.7. View

Lele A, Alunpipatthanachai B, Clark-Bell C, Watanitanon A, Min Xu M, Anne Moore R . Cardiac-cerebral-renal associations in pediatric traumatic brain injury: Preliminary findings. J Clin Neurosci. 2020; 76:126-133. DOI: 10.1016/j.jocn.2020.04.021. View

Lian H, Xu X, Shen X, Chen J, Mao D, Zhao Y . Early prediction of cerebral-cardiac syndrome after ischemic stroke: the PANSCAN scale. BMC Neurol. 2020; 20(1):272. PMC: 7341669. DOI: 10.1186/s12883-020-01833-x. View

Chan J, Edwards N, Khandheria B, Shiino K, Sabapathy S, Anderson B . A new approach to assess myocardial work by non-invasive left ventricular pressure-strain relations in hypertension and dilated cardiomyopathy. Eur Heart J Cardiovasc Imaging. 2018; 20(1):31-39. DOI: 10.1093/ehjci/jey131. View

Olivato S, Nizzoli S, Cavazzuti M, Casoni F, Nichelli P, Zini A . e-NIHSS: an Expanded National Institutes of Health Stroke Scale Weighted for Anterior and Posterior Circulation Strokes. J Stroke Cerebrovasc Dis. 2016; 25(12):2953-2957. DOI: 10.1016/j.jstrokecerebrovasdis.2016.08.011. View

Hubert A, Le Rolle V, Leclercq C, Galli E, Samset E, Casset C . Estimation of myocardial work from pressure-strain loops analysis: an experimental evaluation. Eur Heart J Cardiovasc Imaging. 2018; 19(12):1372-1379. DOI: 10.1093/ehjci/jey024. View

Russell K, Eriksen M, Aaberge L, Wilhelmsen N, Skulstad H, Remme E . A novel clinical method for quantification of regional left ventricular pressure-strain loop area: a non-invasive index of myocardial work. Eur Heart J. 2012; 33(6):724-33. PMC: 3303715. DOI: 10.1093/eurheartj/ehs016. View

Qian R, Yang W, Wang X, Xu Z, Liu X, Sun B . Evaluation of cerebral-cardiac syndrome using echocardiography in a canine model of acute traumatic brain injury. Am J Cardiovasc Dis. 2015; 5(1):72-6. PMC: 4447077. View

Cui C, Liu L, Li Y, Liu Y, Huang D, Hu Y . Left Ventricular Pressure-Strain Loop-Based Quantitative Examination of the Global and Regional Myocardial Work of Patients with Dilated Cardiomyopathy. Ultrasound Med Biol. 2020; 46(10):2834-2845. DOI: 10.1016/j.ultrasmedbio.2020.06.008. View

10.

Edwards N, Scalia G, Shiino K, Sabapathy S, Anderson B, Chamberlain R . Global Myocardial Work Is Superior to Global Longitudinal Strain to Predict Significant Coronary Artery Disease in Patients With Normal Left Ventricular Function and Wall Motion. J Am Soc Echocardiogr. 2019; 32(8):947-957. DOI: 10.1016/j.echo.2019.02.014. View

11.

Fortuni F, Butcher S, van der Kley F, Lustosa R, Karalis I, de Weger A . Left Ventricular Myocardial Work in Patients with Severe Aortic Stenosis. J Am Soc Echocardiogr. 2020; 34(3):257-266. DOI: 10.1016/j.echo.2020.10.014. View

12.

Yao M, Herve D, Allili N, Jouvent E, Duering M, Dichgans M . NIHSS scores in ischemic small vessel disease: a study in CADASIL. Cerebrovasc Dis. 2012; 34(5-6):419-23. DOI: 10.1159/000345067. View

13.

Yip H, Chang L, Chang W, Lu C, Liou C, Lan M . Level and value of circulating endothelial progenitor cells in patients after acute ischemic stroke. Stroke. 2007; 39(1):69-74. DOI: 10.1161/STROKEAHA.107.489401. View

14.

Liu F, Wang X, Zhang C . Quantitative assessment of left ventricular myocardial work in chronic kidney disease patients by a novel non-invasive pressure-strain loop analysis method. Int J Cardiovasc Imaging. 2021; 37(5):1567-1575. DOI: 10.1007/s10554-020-02132-9. View

15.

Sposato L, J Hilz M, Aspberg S, Murthy S, Bahit M, Hsieh C . Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020; 76(23):2768-2785. DOI: 10.1016/j.jacc.2020.10.009. View

16.

Kolin A, Norris J . Myocardial damage from acute cerebral lesions. Stroke. 1984; 15(6):990-3. DOI: 10.1161/01.str.15.6.990. View

17.

Galli E, Leclercq C, Hubert A, Bernard A, Smiseth O, Mabo P . Role of myocardial constructive work in the identification of responders to CRT. Eur Heart J Cardiovasc Imaging. 2017; 19(9):1010-1018. DOI: 10.1093/ehjci/jex191. View

18.

Yoshimura S, Toyoda K, Ohara T, Nagasawa H, Ohtani N, Kuwashiro T . Takotsubo cardiomyopathy in acute ischemic stroke. Ann Neurol. 2008; 64(5):547-54. DOI: 10.1002/ana.21459. View

19.

Li P, Zhang Y, Li L, Chen Y, Li Z, Liu S . Assessment of left ventricular systolic function by non-invasive pressure-strain loop area in young male strength athletes. Cardiovasc Ultrasound. 2020; 18(1):45. PMC: 7666446. DOI: 10.1186/s12947-020-00227-w. View

20.

Russell K, Eriksen M, Aaberge L, Wilhelmsen N, Skulstad H, Gjesdal O . Assessment of wasted myocardial work: a novel method to quantify energy loss due to uncoordinated left ventricular contractions. Am J Physiol Heart Circ Physiol. 2013; 305(7):H996-1003. DOI: 10.1152/ajpheart.00191.2013. View