The Correlation between Severity of Neurological Impairment and Left Ventricular Function in Patients after Acute Ischemic Stroke

Abstract

Despite left ventricular (LV) dysfunction increases the risk of incidental acute ischemic stroke (AIS), the association between LV function and severity of neurological deficits after AIS remains unclear. Between November 2015 and October 1017, a total of 99 AIS patients were prospectively enrolled and categorized into two groups based on National Institute of Health Stroke Scale (NIHSS). The AIS patients with NIHSS <6 were allocated into Group 1 (n = 50) and those with NIHSS ≥6 were into Group 2 (n = 49). Echocardiography was performed within 5 days after AIS to assess chamber size, left ventricular ejection fraction (LVEF) and valvular regurgitation. Besides, two inflammatory biomarkers, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), were evaluated on admission. The results showed Group 2 had significantly higher value of NLR and PLR (all p-values < 0.01) but lower LVEF (p = 0.001) and frequency of mitral regurgitation (p = 0.021) than Group 1. The NIHSS and modified Rankin scale were significantly negatively correlated with LVEF, whereas both were significantly positively correlated with NLR and PLR (all p-values < 0.02). Multivariate analysis showed LVEF <65%, aging and inflammation were significantly associated with NIHSS ≥6 (all p-values < 0.01). In conclusion, the AIS patients with NIHSS ≥6 had lower LVEF but more clinically dominant mitral regurgitation and higher NLR and PLR compared to those with NIHSS <6.

Neuro vascular injury profile in CVA patients: A study on correlation between hematological indices and severity score in acute ischemic stroke

“…There is a significant raise in both NLR and PLR in patients with NIHSS score >6 i.e., Group 2. This is consistent with study conducted by Pei Hsun sung et al 31 .…”

Short-Term Outcome in Patients with Acute Ischemic Stroke on the Basis of Admission Plasma D-Dimer Level

“…Elevated D-dimer level is reportedly a determinant of the incidence of ischemic stroke not only in the general population but also in patients with atrial fibrillation (AF) 18 . In this present study, it was observed that the mean D-dimer level was Patients those with MRS of <3 are predicted to have an independent life after stroke obtained by Sung et al 21 . The investigators define MRS ≥3 as moderate to severe acute ischemic stroke.…”

Early neurological deterioration in cardiogenic cerebral embolism due to nonvalvular atrial fibrillation: Predisposing factors and clinical implications

“…The PLR has been used as a convenient novel biomarker indicating inflammation, thrombosis, and plaque instability (Turkmen et al., 2013). Sung et al reported that the PLR correlated with the severity of neurological impairment in patients after AIS (Sung et al., 2019). In addition, Zhang et al recently reported that PLR could predict the severity of AIS and poor 30‐day outcomes (Zhang et al., 2019).…”