Prevalence and clinical correlation of left ventricular systolic dysfunction in african americans with ischemic stroke.
BACKGROUND
The goal of the present study was to determine the prevalence of left ventricular systolic dysfunction (LVSD) and associated clinical correlates in African Americans (AA) diagnosed with ischemic stroke (IS).


METHODS
Retrospective chart analysis was done on all diagnosed AA IS patients between January 2010 and March 2012. Patients with atrial fibrillation were excluded. A total of 147 patients were included in the study. Transthoracic 2-dimensional echocardiography was used to assess left ventricular systolic function, and study groups were categorized as normal, mild, moderate, and severely abnormal, based on the ejection fraction (EF). Available imaging studies were analyzed for data collection. Logistic regression and Pearson chi-square tests were performed.


RESULTS
Normal EF was present in 114 of 147 patients (78%). Mild abnormality was present in 9 of 147 (6%), moderate in 8 of 147 (5%), and severe in 16 of 147 (11%) patients. In patients with mildly reduced EF, smoking was the most common (RF). In patients with moderately and severely reduced EFs, hypertension was the most common RF. History of smoking was commonly found in systolic dysfunction group compared with normal group (P = .001). Logistic regression analysis revealed that smoking and advanced age were the significant predictors for LVSD. Large-vessel IS were more common in systolic dysfunction group than normal EF group (P = .017).


CONCLUSIONS
Prevalence of LVSD in AA with IS was 22% in our study. Smoking was a significant modifiable RF associated with systolic dysfunction. A history of smoking and higher age could predict the occurrence of LVSD. There were more large-vessel IS in patients with LVSD.
Department of Neurology, Howard University Hospital, Washington, District of Columbia.
Saravana
S
Devulapalli
Department of Neurology, Howard University Hospital, Washington, District of Columbia.
Shariff
S
Dunlap
Howard University College of Medicine, Washington, District of Columbia.
Nakia
N
Wilson
Howard University College of Medicine, Washington, District of Columbia.
Stephen
S
Cockburn
Department of Neurology, Howard University Hospital, Washington, District of Columbia. Electronic address: mohan311@gmail.com.
Mohankumar
M
Kurukumbi
Department of Cardiology, Howard University Hospital, Washington, District of Columbia.
Prafulla
P
Mehrotra
Department of Neurology, Howard University Hospital, Washington, District of Columbia.
Annapurni
A
Jayam-Trouth
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology
African Americans; Left ventricular systolic dysfunction; clinical characteristics; ischemic stroke; risk factors