Hemodynamic findings in patients with brain stroke.
BACKGROUND
Standard procedures carried out at a stroke department in patients after a cerebral event may prove insufficient for monitoring hemodynamic indices. Impedance cardiography enables hemodynamic changes to be monitored non-invasively. The aim of the work was to describe hemodynamic parameters in patients with acute phase of ischemic and hemorrhagic stroke and to analyse the correlation between the type of hemodynamic response and long-term prognosis.


METHODS
The 45 consecutive subjects with ischemic stroke and 16 with a hemorrhagic stroke were examined additionally with impedance cardiography during the first day of hospitalization. The heart contractility, pump performance, afterload and preload indices were recorded and calculated automatically and the data analyzed in terms of 6-month mortality.


RESULTS
We found a significant association between the systemic vascular resistance index, Heather index, stroke index, heart rate, systolic and diastolic and mean arterial blood pressure and mortality in patients with ischemic stroke (p = 0.002, p = 0.008, p = 0.012, p = 0.005, p = 0.007, p = 0.009, p = 0.002 respectively). Logistic regression analysis identified the thoracic fluid content as the most significant variable correlating with the non-survival of the patients with ischemic stroke and in the whole group (ischemic and hemorrhagic stroke). The significant parameters were also mean arterial pressure and stroke index in ischemic stroke (the correct answer ratio was 86.67%) and heart rate in the whole group (the correct answer ratio was 80.33%). There were no significant associations in hemorrhagic stroke.


CONCLUSIONS
The hemodynamic parameters correlate with long term prognosis in patients with ischemic brain stroke.
University Centre for Cardiology, Department of Family Medicine, Medical University of Gdansk, Poland.
Janusz
J
Siebert
Piotr
P
Gutknecht
Andrzej
A
Molisz
Bartosz
B
Trzeciak
Walenty
W
Nyka