title: Latent cardiac dysfunction as assessed by echocardiography in bed-bound patients following cerebrovascular accidents: comparison with nutritional status.
abstract: The aim of this study was to elucidate the cardiac function in bed-bound patients following cerebrovascular accidents. In accord with the criteria for activities of daily living (ADL) of the Japanese Ministry of Health, Labour and Welfare, 51 age-matched poststroke patients without heart disease were classified into 3 groups: rank A (house-bound) (n = 16, age, 85 +/- 6 years), rank B (chair-bound) (n = 16, age, 84 +/- 8 years), and rank C (bed-bound) (n = 19, age, 85 +/- 9 years). Using echocardiography, the left ventricular (LV) diastolic function was assessed by the ratio of early filling (E) and atrial contraction (A) transmitral flow velocities (E/A) of LV inflow. LV systolic function was assessed by LV ejection fraction (LVEF), and the Tei index was also measured to assess both LV systolic and diastolic function. No difference was observed in the E/A and LVEF among the 3 groups. The Tei index was higher in rank C (0.56 +/- 0.17) than in rank A (0.39 +/- 0.06) and rank B (0.48 +/- 0.17), and a statistically significant difference was observed between rank A and rank C (P < 0.05). Serum albumin and blood hemoglobin were significantly lower in rank C (3.1 +/- 0.4 and 10.6 +/- 1.8 g/dL) than in rank A (4.1 +/- 0.3 and 12.4 +/- 1.2 g/dL) (P < 0.001 and P < 0.05, respectively). These results indicate that latent cardiac dysfunction and poor nutritional status may exist in bed-bound patients (rank C) following cerebrovascular accidents. The Tei index may be a useful index of cardiac dysfunction in bed-bound patients because it is independent of the cardiac loading condition.
authors.affiliation: Department of Integrated Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Masugata
authors.forename: Shoichi
authors.initials: S
authors.lastname: Senda
authors.forename: Fuminori
authors.initials: F
authors.lastname: Goda
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Yoshihara
authors.forename: Kay
authors.initials: K
authors.lastname: Yoshikawa
authors.forename: Norihiro
authors.initials: N
authors.lastname: Fujita
authors.forename: Takashi
authors.initials: T
authors.lastname: Himoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okuyama
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Taoka
authors.forename: Masanobu
authors.initials: M
authors.lastname: Imai
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kohno
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D012709:Serum Albumin / Q000032:analysis; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology