1. Echocardiographic Abnormalities and Determinants of 1‐Month Outcome of Stroke Among West Africans in the SIREN Study
- Author
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Hemant K. Tiwari, Donna K. Arnett, Mayowa O. Owolabi, Okechukwu S Ogah, Rufus Akinyemi, Albert Akpalu, Bruce Ovbiagele, Lambert Tetteh Appiah, Ganiyu Amusa, Francis Agyekum, Abiodun M. Adeoye, Daniel T. Lackland, Adekunle Fakunle, Carolyn Jenkins, Akpa Matthew Onoja, Oyedunni Arulogun, Akinyemi Aje, Lukman Owolabi, Moyinoluwalogo Faniyan, Reginald Obiako, Fred S. Sarfo, Mulugeta Gebregziabher, Taiwo Olunuga, Kolawole Wahab, Joshua O. Akinyemi, Morenikeji A. Komolafe, Adeseye A Akintunde, and Oladimeji Adebayo
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Systole ,Black People ,Nigeria ,morbidity/mortality ,030204 cardiovascular system & hematology ,Ghana ,Risk Assessment ,Ventricular Function, Left ,03 medical and health sciences ,Disability Evaluation ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Morbidity mortality ,Medicine ,echocardiography ,Humans ,Left ventricular geometry ,Stroke ,Acute stroke ,Original Research ,Aged ,Ventricular Remodeling ,business.industry ,Middle Aged ,medicine.disease ,Prognosis ,Siren (codec) ,3. Good health ,West african ,left ventricular geometry ,Case-Control Studies ,Cerebrovascular Disease/Stroke ,Female ,Hypertrophy, Left Ventricular ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Background Little is known about the relationship between echocardiographic abnormalities and outcome among patients with acute stroke. We investigated the pattern and association of baseline echocardiographic variables with 1‐month disability and mortality among patients with stroke in the SIREN (Stroke Investigative Research and Education Network) study. Methods and Results We enrolled and followed up consecutive 1020 adult patients with acute stroke with baseline transthoracic echocardiography from west Africa. To explore the relationship between echocardiographic variables and 1‐month disability (using modified Rankin scale >3) and fatality, regression models were fitted. Relative risks were computed with 95% CIs. The participants comprised 60% men with a mean age of 59.2±14.6 years. Ischemic stroke was associated with smaller aortic root diameter (30.2 versus 32.5, P =0.018) and septal (16.8 versus 19.1, P P =0.004). Over 90% of patients with stroke had abnormal left ventricular (LV) geometry with eccentric hypertrophy predominating (56.1%). Of 13 candidate variables investigated, only baseline abnormal LV geometry (concentric hypertrophy) was weakly associated with 1‐month disability (unadjusted relative risk, 1.80; 95% CI , 0.97–5.73). Severe LV systolic dysfunction was significantly associated with increased 1‐month mortality (unadjusted relative risk, 3.05; 95% CI , 1.36–6.83). Conclusions Nine of 10 patients with acute stroke had abnormal LV geometry and a third had systolic dysfunction. Severe LV systolic dysfunction was significantly associated with 1 month mortality. Larger studies are required to establish the independent effect and unravel predictive accuracy of this association.
- Published
- 2019