title: Cardiac diastolic dysfunction predicts in-hospital mortality in acute ischemic stroke with atrial fibrillation.
abstract: BACKGROUND
  The aim of this study was to identify whether diastolic dysfunction predicts in-hospital death in ischemic stroke patients with atrial fibrillation.
  
  
  METHODS
  We retrospectively analyzed data from enrolled patients with ischemic stroke patients with atrial fibrillation who presented within 24h of onset. All patients underwent transthoracic echocardiography to evaluate diastolic filling pressure estimated as the ratio of early transmitral flow velocity (E) to mitral annular velocity (e') within 24h of admission. We evaluated initial ischemic lesion volume and National Institute of Health Stroke Scale (NIHSS) score.
  
  
  RESULTS
  Two hundred and sixty-six patients were enrolled. During hospitalization, 30 patients (11%) died. The deceased group had a higher NIHSS score, a higher D-dimer level, a higher creatinine level, a larger initial ischemic lesion volume and a higher E/e' ratio than those in the survival group. In a multivariate analysis, a higher E/e' ratio was an independent predictor of in-hospital death. The cutoff value for the E/e' ratio for prediction in-hospital death was 20 with the sensitivity of 75% and specificity of 86%.
  
  
  CONCLUSIONS
  Diastolic dysfunction may be associated with in-hospital death in ischemic stroke patients with atrial fibrillation.
authors: Cerebrovascular Center, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan. Electronic address: ytate.com@gmail.com.
authors: Yohei
authors: Y
authors: Tateishi
authors: Cerebrovascular Center, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
authors: Akira
authors: A
authors: Tsujino
authors: Cerebrovascular Center, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
authors: Jumpei
authors: J
authors: Hamabe
authors: Department of Cardiology, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
authors: Akira
authors: A
authors: Tsuneto
authors: Department of Cardiology, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
authors: Koji
authors: K
authors: Maemura
authors: Emergency Medical Center, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
authors: Osamu
authors: O
authors: Tasaki
authors: Department of Neurosurgery, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
authors: Nobutaka
authors: N
authors: Horie
authors: Department of Neurosurgery, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
authors: Tsuyoshi
authors: T
authors: Izumo
authors: Department of Neurosurgery, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
authors: Kentaro
authors: K
authors: Hayashi
authors: Department of Neurosurgery, The Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan.
authors: Izumi
authors: I
authors: Nagata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality; D002423:Cause of Death; D005260:Female; D054144:Heart Failure, Diastolic / Q000209:etiology* / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications* / Q000401:mortality; D016019:Survival Analysis
keywords: Atrial fibrillation; Diastolic dysfunction; Mortality; Stroke; Transthoracic echocardiography