Research Article| Volume 345, ISSUE 1-2, P83-86, October 15, 2014

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Cardiac diastolic dysfunction predicts in-hospital mortality in acute ischemic stroke with atrial fibrillation


      • We assessed diastolic dysfunction in ischemic stroke with AF.
      • We defined diastolic dysfunction as a high E/e′ on transthoracic echocardiography.
      • High E/e′ predicted in-hospital death in ischemic stroke patients with AF.



      The aim of this study was to identify whether diastolic dysfunction predicts in-hospital death in ischemic stroke patients with atrial fibrillation.


      We retrospectively analyzed data from enrolled patients with ischemic stroke patients with atrial fibrillation who presented within 24 h 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 24 h of admission. We evaluated initial ischemic lesion volume and National Institute of Health Stroke Scale (NIHSS) score.


      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%.


      Diastolic dysfunction may be associated with in-hospital death in ischemic stroke patients with atrial fibrillation.


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