左室收缩功能障碍与6~24 h内接受机械取栓的急性缺血性脑卒中患者不良预后相关

目的探讨以左室射血分数（LVEF）测量的左室收缩功能障碍（LVSD）与6~24 h内接受机械取栓治疗的前循环大血管闭塞型急性缺血性脑卒中（AIS）患者90 d预后的相关性。 方法回顾性分析2018年1月至2021年1月在发病后6~24 h内于我院接受机械取栓治疗的急性缺血性脑卒中患者资料。根据国际准则采用Simpson双平面法在二维超声心动图上评估LVEF，LVEF < 50%即定义为LVSD。90 d改良Rankin量表（mRS）评分3~6分定义为不良功能预后。采用单因素和多因素Logistic回归分析明确LVSD与90 d不良预后的相关性。 结果共计纳入了107例患者,其中26例（24.3%）术后出现了LVSD。多因素分析显示，LVSD（OR = 4.206，95%CI：1.357~13.035，P = 0.013）、美国国立卫生研究院卒中量表（NIHSS）基线评分高（OR = 1.234，95%CI：1.114~1.367，P < 0.001）、再灌注不良（mTICI 0~2a） （OR = 4.388，95%CI：1.373~14.023，P = 0.013）是90 d不良功能预后的独立危险因素。年龄（OR = 1.081，95%CI：1.005~1.161，P = 0.035）、LVSD （OR = 3.783，95%CI：1.029~13.911，P = 0.045）、美国国立卫生研究院卒中量表（NIHSS）基线评分高（OR = 1.109，95%CI：1.026~1.198，P = 0.009）是90 d死亡率的独立危险因素。 结论LVSD与6~24 h接受机械取栓治疗的急性缺血性脑卒中患者90 d不良预后独立相关。

Left ventricular systolic dysfunction is associated with poor clinical outcomes in acute ischemic stroke patients treated with endovascular thrombectomy between 6-24 h

ObjectiveTo evaluate the association between left ventricular systolic dysfunction (LVSD) measured by left ventricular ejection fraction (LVEF) and 90 d clinical outcomes in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) in the anterior cerebral circulation who underwent endovascular thrombectomy (EVT) between 6-24 h. MethodsThe clinical data of AIS patients with LVO in the anterior cerebral circulation who underwent EVT between 6-24 h after symptom onset in our hospita from January 2018 to January 2021 were retrospectively analyzed. LVEF was measured on two-dimensional echocardiography using Simpson's biplane method of discs according to international guidelines. LVSD was defined as LVEF < 50%. A modified Rankin Scale (mRS) of 3-6 at 90 d was defined as a poor functional outcome. The univariate and multivariate logistic regression analyses were used to access the correlation between LVSD and 90 d poor clinical outcome. ResultsA total of 107 patients were enrolled in this study, of whom 26 (24.3%) patients had LVSD. On multivariate analyses, LVSD (OR =4.206, 95%CI: 1.357-13.035, P = 0.013), baseline high National Institutes of Health Stroke Scale (NIHSS) score (OR = 1.234, 95%CI: 1.114-1.367, P < 0.001) and poor reperfusion (mTICI 0-2a) (OR = 4.388, 95%CI: 1.373-14.023, P=0.013) were independent predictors of 90 d poor functional outcomes. Age(OR = 1.081, 95%CI: 1.005-1.161, P = 0.035), LVSD (OR = 3.783, 95%CI: 1.029-13.911, P = 0.045), and baseline high National Institutes of Health Stroke Scale (NIHSS) score (OR = 1.109, 95%CI: 1.026-1.198, P = 0.009) were independent risk factors for 90 d mortality. ConclusionsLVSD was independently associated with 90 d poorer outcomes in AIS patients with LVO in the anterior circulation who underwent EVT between 6-24 h.