title: Association between Left Ventricular Dysfunction and Functional Outcomes at Three Months in Acute Ischemic Stroke.
abstract: BACKGROUND
  Left ventricular dysfunction (LVD) was associated with stroke occurrence and mortality. However, few studies have published the impact of LVD on functional stroke outcomes in the acute stroke period.
  
  
  METHODS
  We enrolled 1554 patients who were admitted to Dong-A University Hospital between January 2011 and November 2014. To determine the functional outcomes, the modified Rankin Scale (mRS) score at 3 months after stroke was used. The severity of LVD was defined depending on ejection fraction (EF): (1) severe (EF ≤ 40%); (2) mild (40% < EF < 55%); and (3) normal (EF ≥ 55%). EF was measured using transthoracic two-dimensional echocardiography. The distribution of mRS scores at 3 months after stroke was presented using LVD. Multivariable analysis was performed to predict poor functional outcomes.
  
  
  RESULTS
  Of the 1554 patients, 1417 had normal LV function, 87 had mild LVD, and 50 had severe LVD. Patients with LVD were older and had a high incidence of diabetes mellitus, atrial fibrillation, coronary artery disease, and severe stroke symptoms. With respect to treatment, patients with LVD received more thrombolysis and more anticoagulation medication after stroke. Stroke-related disability at discharge and at 3 months was significantly associated with LVD. In the multivariable analyses, old age, diabetes mellitus, high initial National Institutes of Health Stroke Scale score, stroke mechanism, and LVD were independent predictors of poor functional outcomes at 3 months.
  
  
  CONCLUSIONS
  LVD is associated with poor functional outcomes after acute ischemic stroke.
authors.affiliation: Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
authors.forename: Wook-Joo
authors.initials: WJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, College of Medicine, Dong-A University, Busan, Republic of Korea.
authors.forename: Hyun-Wook
authors.initials: HW
authors.lastname: Nah
authors.affiliation: Department of Neurology, College of Medicine, Dong-A University, Busan, Republic of Korea.
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Neurology, College of Medicine, Dong-A University, Busan, Republic of Korea. Electronic address: nrcjk65@gmail.com.
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Cha
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D004452:Echocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000209:etiology*
keywords: Left ventricular dysfunction; cerebral infarction; functional outcome; heart failure