Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study

Abstract Recent evidence indicates that our understanding of the relationship between cardiac function and ischemic stroke remains incomplete. The Cardiovascular Health Study enrolled community-dwelling adults ≥ 65 years old. We included participants with speckle-tracking data from digitized baselin...

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Autores principales:	Hooman Kamel, Traci M. Bartz, W. T. Longstreth, Mitchell S. V. Elkind, John Gottdiener, Jorge R. Kizer, Julius M. Gardin, Jiwon Kim, Sanjiv Shah
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b91dd47fb7264f51bd53576b2b5a426d
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spelling	oai:doaj.org-article:b91dd47fb7264f51bd53576b2b5a426d2021-12-02T16:38:49ZCardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study10.1038/s41598-021-96702-z2045-2322https://doaj.org/article/b91dd47fb7264f51bd53576b2b5a426d2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96702-zhttps://doaj.org/toc/2045-2322Abstract Recent evidence indicates that our understanding of the relationship between cardiac function and ischemic stroke remains incomplete. The Cardiovascular Health Study enrolled community-dwelling adults ≥ 65 years old. We included participants with speckle-tracking data from digitized baseline study echocardiograms. Exposures were left atrial reservoir strain (primary), left ventricular longitudinal strain, left ventricular early diastolic strain rate, septal e’ velocity, and lateral e’ velocity. The primary outcome was incident ischemic stroke. Cox proportional hazards models were adjusted for demographics, image quality, and risk factors including left ventricular ejection fraction and incident atrial fibrillation. Among 4,000 participants in our analysis, lower (worse) left atrial reservoir strain was associated with incident ischemic stroke (HR per SD absolute decrease, 1.14; 95% CI 1.04–25). All secondary exposure variables were significantly associated with the outcome. Left atrial reservoir strain was associated with cardioembolic stroke (HR per SD absolute decrease, 1.42; 95% CI 1.21–1.67) and cardioembolic stroke related to incident atrial fibrillation (HR per SD absolute decrease, 1.60; 1.32–1.95). Myocardial dysfunction that can ultimately lead to stroke may be identifiable at an early stage. This highlights opportunities to identify cerebrovascular risk earlier and improve stroke prevention via therapies for early myocardial dysfunction.Hooman KamelTraci M. BartzW. T. LongstrethMitchell S. V. ElkindJohn GottdienerJorge R. KizerJulius M. GardinJiwon KimSanjiv ShahNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hooman Kamel Traci M. Bartz W. T. Longstreth Mitchell S. V. Elkind John Gottdiener Jorge R. Kizer Julius M. Gardin Jiwon Kim Sanjiv Shah Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study
description	Abstract Recent evidence indicates that our understanding of the relationship between cardiac function and ischemic stroke remains incomplete. The Cardiovascular Health Study enrolled community-dwelling adults ≥ 65 years old. We included participants with speckle-tracking data from digitized baseline study echocardiograms. Exposures were left atrial reservoir strain (primary), left ventricular longitudinal strain, left ventricular early diastolic strain rate, septal e’ velocity, and lateral e’ velocity. The primary outcome was incident ischemic stroke. Cox proportional hazards models were adjusted for demographics, image quality, and risk factors including left ventricular ejection fraction and incident atrial fibrillation. Among 4,000 participants in our analysis, lower (worse) left atrial reservoir strain was associated with incident ischemic stroke (HR per SD absolute decrease, 1.14; 95% CI 1.04–25). All secondary exposure variables were significantly associated with the outcome. Left atrial reservoir strain was associated with cardioembolic stroke (HR per SD absolute decrease, 1.42; 95% CI 1.21–1.67) and cardioembolic stroke related to incident atrial fibrillation (HR per SD absolute decrease, 1.60; 1.32–1.95). Myocardial dysfunction that can ultimately lead to stroke may be identifiable at an early stage. This highlights opportunities to identify cerebrovascular risk earlier and improve stroke prevention via therapies for early myocardial dysfunction.
format	article
author	Hooman Kamel Traci M. Bartz W. T. Longstreth Mitchell S. V. Elkind John Gottdiener Jorge R. Kizer Julius M. Gardin Jiwon Kim Sanjiv Shah
author_facet	Hooman Kamel Traci M. Bartz W. T. Longstreth Mitchell S. V. Elkind John Gottdiener Jorge R. Kizer Julius M. Gardin Jiwon Kim Sanjiv Shah
author_sort	Hooman Kamel
title	Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study
title_short	Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study
title_full	Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study
title_fullStr	Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study
title_full_unstemmed	Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study
title_sort	cardiac mechanics and incident ischemic stroke: the cardiovascular health study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b91dd47fb7264f51bd53576b2b5a426d
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Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study

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