title: Diastolic Dysfunction and Outcome in Acute Ischemic Stroke.
abstract: BACKGROUND
  Left ventricular diastolic dysfunction (DD) is associated with an increased mortality in general population and patients with myocardial infarct. In the present study, we investigated whether DD is associated with outcomes after ischemic stroke.
  
  
  METHODS
  Five hundred and three acute ischemic stroke patients with normal left ventricular ejection fraction (≥50%) were retrospectively included. Echocardiography and tissue Doppler imaging were used to evaluate and grade diastolic function. Ordinal logistic and Cox regression analyses were used to examine relations between DD and modified Rankin Scale (mRS) score at 3 months and mortality after stroke, respectively.
  
  
  RESULTS
  Mean age was 67.2 ± 11.8 years and 63% were men. Among parameters of diastolic function, early mitral inflow velocity/early diastolic mitral annulus velocity (E/e') was independently related with higher mRS score at 3 months and mortality after ischemic stroke. The highest quartile of E/e' (>14) was independently associated with higher mRS score (adjusted OR 3.86, 95% CI 2.27-6.54) as well as with mortality (hazards ratio [HR] 2.87, 95% CI 1.17-7.04) as compared to the lowest quartile of E/e' (<8.8). In addition, moderate-to-severe DD grade was related to higher mRS score (adjusted OR 2.41, 95% CI 1.15-5.06) and mortality (HR 6.63, 95% CI 1.80-24.43) compared to the normal diastolic function.
  
  
  CONCLUSIONS
  In patients with ischemic stroke, DD is associated with functional outcome at 3 months and mortality. Our data suggest that more attention should be given to DD in patients with ischemic stroke.
authors.affiliation: Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Wi-Sun
authors.initials: WS
authors.lastname: Ryu
authors.forename: Jun-Bean
authors.initials: JB
authors.lastname: Park
authors.forename: Sang-Bae
authors.initials: SB
authors.lastname: Ko
authors.forename: Seung-sik
authors.initials: SS
authors.lastname: Hwang
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Dong-Eog
authors.initials: DE
authors.lastname: Kim
authors.forename: Seung-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Byung-Woo
authors.initials: BW
authors.lastname: Yoon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology*; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000503:physiopathology* / Q000628:therapy*; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*