Details
Category: Volume 11 Issue 02 February 2023
Hits: 543

Title: Echocardiographic evaluation of left ventricular function in patients with acute onset stroke and its prognostic significance

Authors: Samavedam Janakirama Karthik, K. Rohith Kumar, M. Sriharibabu, SV Ramana Murthy

 DOI: https://dx.doi.org/10.18535/jmscr/v11i2.12

Abstract

Introduction: Research was conducted to determine if 2D echocardiography changes in various types of cerebrovascular accidents had any prognostic significance. With this a study was conducted to evaluate left ventricular function in acute onset stroke using 2D-Echocardiography.

Methods: It was a cross-sectional study conducted in the department of General medicine of GSL Medical College. Study was conducted between October 2019 and March 2021.The study protocol was approved by the institutional ethics committee. Informed written consent was obtained from all the study participants. Those <20 years, traumatic patients with neurological defects, those with abnormal 2D echo findings, neoplastic patients, unwilling individuals were excluded from the research. Detailed neurological examination, including fundoscopy and cardiovascular examination, were carried. Necessary relevant investigations such as hematological parameters, 2D Echo, ECG were carried as per the institutional protocol. Results were analyzed regarding age, sex, and other risk factors and in relation to Echocardiographic evaluation of left ventricular function. P <0.05 was considered statistically significant.

Results: Majority were in 50 – 59 (30.4%) years group; the mean age was 56.13 ± 14.07 years. Male female ratio was 1.7. Hypertension was the leading (51%; 47) risk factor. CT findings reveal that 68.48% (63) had ischemic stroke (IS) Among the IS, normal ECG was detected in 20.6% and it was 6.6% in HS group. Those showed abnormal ECG changes, 48.9% were survived and 23.9% were dead. In the normal ECG findings, it was 22.8% and 4.35%, respectively.

Conclusions: IS was the leading risk factor. With ECHO, statistically there was significant in the dead criteria. Small sample size and short duration are the limitations of this research.

Keywords: Stoke, hypertension, patients.

References

  1. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation, a major contributor to stroke to stroke in the elderly: the Framingham study. Arch Intern Med 1987; 147: 1561 – 4.
  2. Prasad K, Vibha D, Meenakshi. Cerebrovascular disease in South Asia – Part I: A burningproblem. JRSM Cardiovasc Dis [Internet]. 2012 Oct 31 [cited 2016 Oct 25];1(7). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738368/
  3. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet Lond Engl. 2014;383(9913):245–54.
  4. Dalal PM, Malik S, Bhattacharjee M, Trivedi ND, Vairale J, Bhat P, et al. Population-based stroke survey in Mumbai, India: incidence and 28-day case fatality. Neuroepidemiology. 2008;31 (4):254– 61.
  5. Kulshrestha M, Vidyanand. An Analysis of the Risk Factors and the Outcomes of Cerebrovascular Diseases in Northern India. J Clin Diagn Res J Clin Diag Rese. 2013;7(1):127–31.
  6. Davies KR, GelbAW, Manninen PH,B oughner DR, Bisnaire D. Cardiac function in aneurysmal SAH - A study of electrocardiographic and echocardiographic abnormalities. Brit JAne. 1991;67(1): 58 – 63.
  7. Sakka SG, Haettemann E, Reinhart K. Acute left ventricular dysfunction and SAH. J.Neurosurg.Anesthesiol. 1999; 11(3):209 – 13.
  8. Nambiar V, Raj M, Vasudevan D, Bhaskaran R, Sudevan R. One-year mortality after acute stroke: a prospective cohort study from a comprehensive stroke care centre, Kerala, India. BMJ Open. 2022;12(11):e061258.
  9. Venkataraman S, Bhargava S, Virmani V. Cerebrovascular accidents: clinical and radiological features. J Assoc Physicians India. 1977; 25(8):523-9.
  10. Di Carlo A, Lamassa M, Baldereschi M, Pracucci G, Basile AM, Wolfe CD, Giroud M, Rudd A, Ghetti A, Inzitari D; European BIOMED Study of Stroke Care Group. Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: data from a multicenter multinational hospital-based registry. Stroke. 2003; 34(5):1114-9.
  11. Nagaraja D, Gururaj G, Girish N, Panda S, Roy AK, Sarma GRK, et al. Feasibility study of stroke surveillance: data from Bangalore, India. Indian J Med Res. 2009;130(4):396–403.
  12. Reeves MJ, Bushnell CD, Howard G, Gargano JW, Duncan PW, Lynch G, et al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. Lancet Neurol. 2008;7(10):915–26.
  13. Fekadu G, Chelkeba L, Kebede A. Risk factors, clinical presentations and predictors of stroke among adult patients admitted to stroke unit of Jimma university medical center, south west Ethiopia: prospective observational study. BMC Neurol. 2019;19(1):187.
  14. Daniele O, Caravaglios G, Fierro B, Natalè E. Stroke and cardiac arrhythmias. Journal of Stroke & Cerebrovascular Disease. 2002 Jan-Feb; 11(1): 28-33.
  15. Roy MK Mikolich JR, Jacobs WC, Fletcher GF. Cardiac arrhythmias in patients with acute cerebrovascular accidents. JAMA. 1981;12: 246.
  16. Purushothaman S, Salmani D, Prarthana KG, Bandelkar SM, Varghese S. Study of ECG changes and its relation to mortality in cases of cerebrovascular accidents. J Nat Sci Biol Med. 2014;5(2):434 – 6.
  17. Togha M, Sharifpour A, Ashraf H, Moghadam M, Sahraian MA. Electrocardiographic abnormalities in acute cerebrovascular events in patients with/without cardiovascular disease. Ann Indian Acad Neurol. 2013; 16(1): 66 – 71.

Corresponding Author

Samavedam Janakirama Karthik

Junior Resident, Department of General Medicine, GSL Medical College, Rajahmundry