Association between Ischemic Stroke and Left Ventricular Systolic Dysfunction

Abstract

Background: Globally, Ischemic stroke (IS) is a major cause of morbidity and mortality. Left ventricular systolic dysfunction (LVSD) has been reported as an important clinical predictor of ischemic stroke. LVSD may involve in the pathophysiology of IS through different mechanisms. It has been suggested that LVSD may predispose to in situ thrombosis as well as proximal thrombosis formation, leading to intracranial vascular occlusion after detachment which decreases global cerebral blood flow. In addition, LVSD causes a state of global cerebral hypoperfusion with decreased brain blood flow and cerebrovascular reactivity, which contributes to a higher risk of ischemic insult. It is hypothesized that LVSD assessed using the LVEF may be associated with an unfavorable functional outcome after IS.

Purpose: To determine the left ventricular systolic dysfunction among the ischemic stroke patients.

Materials & method: This case-control study was conducted in Department of Neurology and Cardiology, Bangladesh Medical University (BMU), Dhaka from July 2008 to June 2010. A total 120 subjects were selected and allocated in to two groups; Group-A (case group or patients with ischemic stroke) and Group-B (control group or age-sex matched non-stroke volunteer). LV ejection fraction (LVEF,%) was used for assessing systolic dysfunction, and LVSD was classified as normal (EF ³50%), mild dysfunction (EF 41–50%), moderate dysfunction (EF 31–40%), and severe dysfunction (EF <30%).

Result: Mean age was 57.83±12.09 years and 58.02±12.34 years in case and control respectively. Out of 120 cases, total 86(71.7%) were male and 34(28.3%) were female. Male – female ratio was 2.52:1. Out of all stroke patients, 45(75.0%) had normal LV function and 15(25.0%) had LV systolic dysfunction. Mean±SD of LVEF was 57.33±10.26 and 63.62±7.78 in case and control respectively. It was found that mild LV dysfunction was observed in 16.7% cases of stroke patients, whereas it was 1.7% in control group. Moderate LV dysfunction was observed in 8.3% in stroke patients, only 1.7% in control group. The differences were statistically significant (P < 0.05), means left ventricular systolic dysfunction is significant predictor of ischemic stroke.

Conclusion: Present data concluded that Left Ventricular Systolic Dysfunction is independently associated with an increased risk of ischemic stroke.

 J Dhaka Med Coll. 2025; 34(2) : 91-97