Introduction: Neurologic Disorders are known to be associated to transient left ventricular (LV) dysfunction mainly on subarachnoid hemorrhage, namely “neurogenic stunned myocardium” (NSM). However, the impact of transient cardiac dysfunction on prognosis has not fully investigated in patients with ischemic stroke.
Methods: Between December 2010 and November 2016, consecutive 3505 patients with acute ischemic stroke patients aged 18 years and more were registered in National Cerebral Cardiovascular Center. Among them, excluded 8 patients with prior myocardial infarction, we finally retrospectively analyzed 2786 patients who underwent screening echocardiography both on admission and at the discharge. They were divided into the two groups with and without the NSM. The NSM of transient LV asynergy was defined as that LV asynergy on admission was improved at the discharge.
Results: The NSM was found in 15 patients (0.5%), in whom LV ejection fraction was improved from 36% (interquartile range: 25-47) on admission to 56% (interquartile range: 51-62) at discharge. In NSM group, age, proportion of females and score of NIHSS were significantly higher compared with Non-NSM group (age: 83 vs. 75 years, p=0.0004, female: 80 vs. 39%, p=0.002, NIHSS: 18 vs. 4 points, p=0.0006), while there was no significant differences in type of ischemic stroke and lesion site between NSM group and Non-NSM group. Importantly, NSM group had significantly more adverse cardiovascular events including death, lethal arrhythmia, acute myocardial infarction and acute decompensated heart failure during 30 days hospitalization than Non- NSM group (53% vs. 2%, p=0.0001). After the adjustment with age, gender and NIHSS on admission, NSM was an independent risk factor for adverse cardiovascular events during hospitalization (HR 10.68, CI 1.94-198.65, p=0.0039).
Conclusions: Our study demonstrated that acute ischemic stroke patients complicated with NSM appear to be a high-risk population with increased rate of adverse cardiovascular events during 30 days hospitalization, although the NSM was transient.