Tan, Benjamin Y. Q., Leow, Aloysius S. T., Lee, Tsong-Hai, Gontu, Vamsi Krishna, Andersson, Tommy, Holmin, Staffan, Wong, Ho-Fai, Lin, Chuan-Min, Cheng, Chih-Kuang, Sia, Ching-Hui, Ngiam, Nicholas, Ng, Zhi-Xuan, Yeo, Joshua, Chan, Bernard, Teoh, Hock-Luen, Seet, Raymond, Paliwal, Prakash, Anil, Gopinathan ORCID: 0000-0002-8192-1287, Yang, Cunli, Maus, Volker, Abdullayev, Nuran ORCID: 0000-0003-4522-537X, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164, Bhogal, Pervinder, Wong, Ken, Makalanda, Hegoda Levansri Dilrukshan, Spooner, Oliver, Amlani, Sageet, Campbell, Daniel, Michael, Robert, Quaschling, Ulf, Schob, Stefan, Maybaum, Jens, Sharma, Vijay Kumar and Yeo, Leonard L. L. (2021). Left ventricular systolic dysfunction is associated with poor functional outcomes after endovascular thrombectomy. J. NeuroInterventional Surg., 13 (6). S. 515 - 520. LONDON: BMJ PUBLISHING GROUP. ISSN 1759-8486

Full text not available from this repository.

Abstract

Background Endovascular thrombectomy (ET) has transformed acute ischemic stroke (AIS) therapy in patients with large vessel occlusion (LVO). Left ventricular systolic dysfunction (LVSD) decreases global cerebral blood flow and predisposes to hypoperfusion. We evaluated the relationship between LVSD, as measured by LV ejection fraction (LVEF), and clinical outcomes in patients with anterior cerebral circulation LVO who underwent ET. Methods This multicenter retrospective cohort study examined anterior circulation LVO AIS patients from six international stroke centers. LVSD was measured by assessment of the echocardiographic LVEF using Simpson's biplane method of discs according to international guidelines. LVSD was defined as LVEF <50%. The primary outcome was defined as a good functional outcome using a modified Rankin Scale (mRS) of 0-2 at 3 months. Results We included 440 AIS patients with LVO who underwent ET. On multivariate analyses, pre-existing diabetes mellitus (OR 2.05, 95% CI 1.24 to 3.39;p=0.005), unsuccessful reperfusion (Treatment in Cerebral Infarction (TICI) grade 0-2a) status (OR 4.21, 95% CI 2.04 to 8.66; p<0.001) and LVSD (OR 2.08, 95% CI 1.18 to 3.68; p=0.011) were independent predictors of poor functional outcomes at 3 months. On ordinal (shift) analyses, LVSD was associated with an unfavorable shift in the mRS outcomes (OR 2.32, 95% CI 1.52 to 3.53; p<0.001) after adjusting for age and ischemic heart disease. Conclusion Anterior circulation LVO AIS patients with LVSD have poorer outcomes after ET, suggesting the need to consider cardiac factors for ET, the degree of monitoring and prognostication post-procedure.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Tan, Benjamin Y. Q.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leow, Aloysius S. T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lee, Tsong-HaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gontu, Vamsi KrishnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Andersson, TommyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holmin, StaffanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wong, Ho-FaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lin, Chuan-MinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cheng, Chih-KuangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sia, Ching-HuiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ngiam, NicholasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ng, Zhi-XuanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yeo, JoshuaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chan, BernardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Teoh, Hock-LuenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seet, RaymondUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paliwal, PrakashUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Anil, GopinathanUNSPECIFIEDorcid.org/0000-0002-8192-1287UNSPECIFIED
Yang, CunliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maus, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Abdullayev, NuranUNSPECIFIEDorcid.org/0000-0003-4522-537XUNSPECIFIED
Mpotsaris, AnastasiosUNSPECIFIEDorcid.org/0000-0002-1275-8164UNSPECIFIED
Bhogal, PervinderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wong, KenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Makalanda, Hegoda Levansri DilrukshanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spooner, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Amlani, SageetUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Campbell, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Michael, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Quaschling, UlfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schob, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maybaum, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sharma, Vijay KumarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yeo, Leonard L. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-601884
DOI: 10.1136/neurintsurg-2020-016216
Journal or Publication Title: J. NeuroInterventional Surg.
Volume: 13
Number: 6
Page Range: S. 515 - 520
Date: 2021
Publisher: BMJ PUBLISHING GROUP
Place of Publication: LONDON
ISSN: 1759-8486
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ACUTE ISCHEMIC-STROKE; HEART-FAILURE; MECHANICAL THROMBECTOMY; RECOMMENDATIONS; PREDICTORS; GUIDELINES; MANAGEMENT; THERAPY; SOCIETY; TRIALMultiple languages
Neuroimaging; SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60188

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item