Left ventricular systolic dysfunction and the risk of ischemic stroke in a multiethnic population

• Published in: Stroke (1970) 2006-07, Vol.37 (7), p.1715-1719
• Main Authors: HAYS, Allison G, SACCO, Ralph L, RUNDEK, Tanja, SCIACCA, Robert R, ZHEZHEN JIN, RUI LIU, HOMMA, Shunichi, DI TULLIO, Marco R
• Format: Article
• Language: English
• Subjects: Adult; African Americans - statistics & numerical data; Aged; Aged, 80 and over; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Brain Ischemia - epidemiology; Brain Ischemia - ethnology; Brain Ischemia - etiology; Cohort Studies; Diabetes Mellitus - epidemiology; Echocardiography; European Continental Ancestry Group - statistics & numerical data; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Hispanic Americans - statistics & numerical data; Humans; Hypertension - epidemiology; Incidence; Intracranial Embolism - complications; Intracranial Embolism - epidemiology; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; New York City - epidemiology; Odds Ratio; Pharmacology. Drug treatments; Risk Factors; Sampling Studies; Smoking - epidemiology; Stroke Volume; Systole; Vascular diseases and vascular malformations of the nervous system; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - epidemiology; Ventricular Dysfunction, Left - ethnology
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.0000227121.34717.40

Left ventricular dysfunction (LVD) is associated with cardiovascular mortality. Its association with ischemic stroke has been mainly documented after myocardial infarction. The stroke risk associated with LVD, especially of mild degree, in the general population is unclear. The purpose of this study was to evaluate the relationship between LVD and ischemic stroke in a multiethnic cohort. LV systolic function was assessed by transthoracic 2-dimensional echocardiography in a subset of subjects from the Northern Manhattan Study (NOMAS), 270 patients with first ischemic stroke and 288 age-, gender- and race-matched community controls. LV ejection fraction was measured by a simplified cylinder-hemiellipsoid formula, and categorized as normal (>50%), mildly (41% to 50%), moderately (31% to 40%) or severely (< or =30%) decreased. The association between impaired ejection fraction and ischemic stroke was evaluated by logistic regression analysis after adjustment for established stroke risk factors. LVD of any degree was more frequent in stroke patients (24.1%) than in controls (4.9%; P