EJEKCIONA FRAKCIJA LEVE KOMORE I ANTEROPOSTERIORNI DIJAMETAR LEVE PRETKOMORE KAO PREDIKTORI ISHODA AKUTNOG ISHEMIJSKOG MOŽDANOG UDARA
Sažetak
Uvod: Akutni moždani udar predstavlja značajno zdravstveno opterećenje. Kako su varijable dobijene transtorakalnom ehokardiografijom dokazani prediktori ishoda kardioloških oboljenja, pokušali smo da utvrdimo njihov značaj u predikciji ishoda ove grupe bolesnika.
Cilj rada je dokazivanje hipoteze da je uvećanje leve pretkomore iskazano porastom anteroposteriornog dijametra kao i pad sistolne fukcije leve komore, posmatran vrednošću ejekcione frakcije, prediktor lošeg ishoda kod ovih bolesnika.
Materijal i metode: Osnov metodologije je analiza podataka 106 bolesnika sa akutnim ishemijskim moždanim udarom uz podatke o modifikovanom Rankin skoru na otpustu, koji su pokazatelj funkcionalnog ishoda oboljenja.
Rezultati: Pokazana je korelacija između funkcionalnog ishoda bolesti u odnosu na ejekcionu frakciju leve komore. Opadanjem ejekcione frakcije leve komore raste mogućnost lošijeg ishoda bolesti. Veličina leve pretkomore je takođe testirana kao prediktor lošijeg ishoda u smislu veće leve pretkomore povezane sa lošijim ishodom bolesti, a hipoteza se i ovde pokazala tačnom, s obzirom da postoji korelacija veličine njenog prečnika u odnosu na ishod bolesti.
Zaključak: Od praćenih parametara, prediktivnu vrednost ka ishodu bolesti pokazuje ejekciona frakcija leve komore, kao i veličina levog atrijuma, a u odnosu na funkcionalni ishod bolesti.
Reference
GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021 Oct;20(10):795-820. doi: 10.1016/S1474-4422(21)00252-0.
Pu L, Wang L, Zhang R, Zhao T, Jiang Y, Han L. Projected global trends in ischemic stroke incidence, deaths and disability-adjusted life years from 2020 to 2030. Stroke. 2023 May;54(5):1330-9. doi: 10.1161/STROKEAHA.122.040073.
Imoisili OE, Chung A, Tong X, Hayes DK, Loustalot F. Prevalence of stroke – behavioral risk factor surveillance system, United States, 2011-2022. MMWR Morb Mortal Wkly Rep. 2024 May 23;73(20):449-55. doi: 10.15585/mmwr.mm7320a1.
Toma M, Ezekowitz JA, Bakal JA, O'Connor CM, Hernandez AF, Sardar MR, et al. The relationship between left ventricular ejection fraction and mortality in patients with acute heart failure: insights from the ASCEND-HF Trial. Eur J Heart Fail. 2014 Mar;16(3):334-41. doi: 10.1002/ejhf.19.
Solomon SD, Anavekar N, Skali H, McMurray JJ, Swedberg K, Yusuf S, et al.; Candesartan in Heart Failure Reduction in Mortality (CHARM) Investigators. Influence of ejection fraction on cardiovascular outcomes in a broad spectrum of heart failure patients. Circulation. 2005 Dec 13;112(24):3738-44. doi: 10.1161/CIRCULATIONAHA.105.561423.
Curtis JP, Sokol SI, Wang Y, Rathore SS, Ko DT, Jadbabaie F, et al. The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure. J Am Coll Cardiol. 2003 Aug 20;42(4):736-42. doi: 10.1016/s0735-1097(03)00789-7.
Di Tullio MR, Qian M, Thompson JL, Labovitz AJ, Mann DL, Sacco RL, et al.; WARCEF Investigators. Left ventricular ejection fraction and risk of stroke and cardiac events in heart failure: Data from the Warfarin Versus Aspirin in Reduced Ejection Fraction Trial. Stroke. 2016 Aug;47(8):2031-7. doi: 10.1161/STROKEAHA.116.013679.
Rahmayani F, Paryono, Setyopranoto I. The role of ejection fraction to clinical outcome of acute ischemic stroke patients. J Neurosci Rural Pract. 2018 Apr-Jun;9(2):197-202. doi: 10.4103/jnrp.jnrp_490_17.
Wrigley P, Khoury J, Eckerle B, Alwell K, Moomaw CJ, Woo D, et al. Prevalence of positive troponin and echocardiogram findings and association with mortality in acute ischemic stroke. Stroke. 2017 May;48(5):1226-32. doi: 10.1161/STROKEAHA.116.014561.
Ziaeian B, Xu H, Matsouaka RA, Xian Y, Khan Y, Schwamm LS, et al. US surveillance of acute ischemic stroke patient characteristics, care quality, and outcomes for 2019. Stroke. 2022 Nov;53(11):3386-93. doi: 10.1161/STROKEAHA.122.039098.
Chee RCH, Lin NH, Ho JSY, Leow AST, Li TYW, Lee ECY, et al. Left ventricular ejection fraction association with acute ischemic stroke outcomes in patients undergoing thrombolysis. J Cardiovasc Dev Dis. 2023 May 25;10(6):231. doi: 10.3390/jcdd10060231.
Wei N, Wei Y, Nie X, Liu X, Xiang X, Pan Y, et al. Effect of left ventricular ejection fraction Spectrum on 1-Year mortality in patients with acute ischemic stroke or transient ischemic attack. CNS Neurosci Ther. 2023 Nov;29(11):3518-27. doi: 10.1111/cns.14285.
Milionis H, Faouzi M, Cordier M, D'Ambrogio-Remillard S, Eskandari A, Michel P. Characteristics and early and long-term outcome in patients with acute ischemic stroke and low ejection fraction. Int J Cardiol. 2013 Sep 30;168(2):1082-7. doi: 10.1016/j.ijcard.2012.11.036.
Xu Y, Zhao L, Zhang L, Han Y, Wang P, Yu S. Left atrial enlargement and the risk of stroke: a meta-analysis of prospective cohort studies. Front Neurol. 2020 Feb 14;11:26. doi: 10.3389/fneur.2020.00026.
Hamatani Y, Ogawa H, Takabayashi K, Yamashita Y, Takagi D, Esato M, et al. Left atrial enlargement is an independent predictor of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Sci Rep. 2016 Aug 3;6:31042. doi: 10.1038/srep31042.
Bouzas-Mosquera A, Broullón FJ, Álvarez-García N, Méndez E, Peteiro J, Gándara-Sambade T, et al. Left atrial size and risk for all-cause mortality and ischemic stroke. CMAJ. 2011 Jul 12;183(10):E657-64. doi: 10.1503/cmaj.091688.
