Association between reduced left ventricular ejection fraction and functional outcomes in acute stroke: Systematic review and meta-analysis

• Published in: Clinical neurology and neurosurgery 2024-11, Vol.246, p.108566, Article 108566
• Main Authors: de Oliveira, Bruno Felipe Santos, de Santana, Cárita Victória Carvalho, Bispo, Rafaela Góes, Oliveira-Filho, Jamary
• Format: Article
• Language: English
• Subjects: Acute ischemic stroke; Bias; Cardiac arrhythmia; Cardiomyopathy; Congestive heart failure; Ejection fraction; Heart; Heart failure; Hemodynamics; Humans; Hypertension; Ischemia; Ischemic Stroke - mortality; Ischemic Stroke - physiopathology; Meta-analysis; Mortality; Neurology; Recovery of Function - physiology; Stroke; Stroke - mortality; Stroke - physiopathology; Stroke Volume - physiology; Systematic review; Thrombectomy; Thrombolysis; Ventricle; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - physiology
• ISSN: 0303-8467; 1872-6968; 1872-6968
• DOI: 10.1016/j.clineuro.2024.108566

Left ventricular ejection fraction (LVEF) is a measure of cardiac function and often reduced LVEF is indicative of cardiomyopathy/heart failure. The current study evaluated whether reduced LVEF is associated with poor outcomes and mortality in acute stroke. Articles that compared poor outcomes (modified Rankin scale 3–6) or mortality in people with reduced LVEF compared to preserved LVEF in acute ischemic stroke were searched in the following databases: MEDLINE/PubMed, Embase, Scopus, Biomed central, and Cochrane Library. The last search was on March 17, 2024. The results obtained were pooled in meta-analyses. A total of 28933 participants were enrolled from 17 articles. Reduced left ventricular ejection fraction was independently associated with poor outcomes at 90 days (OR:2.38 CI95 % 1.52;3.71; I² = 71 %), the same was observed for death at 90 days (OR:3.15 CI 95 % 1.43; 6.96; I² = 60 %). Reduced LVEF is associated with poor functional outcomes and death within 3 months after acute ischemic stroke compared to the setting in which LVEF is preserved. •Left ventricular ejection fraction < 50 % is associated with increased odds of poor outcomes.•Reduced left ventricular ejection fraction was independently associated with poor outcomes at 90 days.•Reduced left ventricular ejection fraction was independently associated with death at 90 days.