Stroke heart injury: the effect of cerebral reperfusion treatment. A 3-year retrospective study.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2024-09-01 Epub Date: 2024-07-15 DOI:10.1007/s00415-024-12531-w

Gabriele Prandin, Giovanni Furlanis, Laura Mancinelli, Federica Palacino, Emanuele Vincis, Ilario Scali, Paola Caruso, Marcello Naccarato, Paolo Manganotti

{"title":"Stroke heart injury: the effect of cerebral reperfusion treatment. A 3-year retrospective study.","authors":"Gabriele Prandin, Giovanni Furlanis, Laura Mancinelli, Federica Palacino, Emanuele Vincis, Ilario Scali, Paola Caruso, Marcello Naccarato, Paolo Manganotti","doi":"10.1007/s00415-024-12531-w","DOIUrl":null,"url":null,"abstract":"Background: Cardiac involvement following an acute stroke (Stroke Heart Syndrome-SHS) is an established complication and it is linked to the involvement of sympathetic activation, inflammation, and neuro-endocrine response. Troponin \"rise and fall pattern\" > 30% is one marker of SHS. The aim of this study was to evaluate the role of reperfusion treatments in the prevention/pathogenesis of SHS with different stroke sizes and locations (OCSP classification).Methods: We retrospectively analyzed data of 890 patients admitted to the Stroke Unit of Trieste (Italy) between 2018 and 2020. Out of them, 411 met the inclusion criteria (acute ischemic non-lacunar stroke). Clinical data were collected for each patient, imaging characteristics, and markers of cardiac injury [troponin I (TnI), NT-proBNP, \"rise and fall pattern\" > 30%]. We compared different stroke subtypes according to OCSP, while evaluating any differences in patients with and without SHS.Results: In treated total anterior circulation infarct (TACI) patients, the rate of SHS is lower than in non-treated TACI. Similar SHS rate was found in partial anterior (PACI) and posterior stroke (POCI), and between treated and non-treated patients. Focusing on TACI group, we compared SHS-TACI and non-SHS-TACI, we performed a univariate and multivariate analysis; treatment (OR 0.408 CI95% 0.185-0.900; p = 0.026) and diabetes (OR 2.618 CI95% 1.181-5.803; p = 0.018) were significantly associated to SHS. No clear insular effect was found in SHS development.Conclusions: In severe anterior stroke (TACI), reperfusion treatment may be effective in preventing SHS. Conversely, diabetes is an independent risk factor for SHS. PACI and POCI have similar troponin elevation rate.","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00415-024-12531-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/15 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Cardiac involvement following an acute stroke (Stroke Heart Syndrome-SHS) is an established complication and it is linked to the involvement of sympathetic activation, inflammation, and neuro-endocrine response. Troponin "rise and fall pattern" > 30% is one marker of SHS. The aim of this study was to evaluate the role of reperfusion treatments in the prevention/pathogenesis of SHS with different stroke sizes and locations (OCSP classification).

Methods: We retrospectively analyzed data of 890 patients admitted to the Stroke Unit of Trieste (Italy) between 2018 and 2020. Out of them, 411 met the inclusion criteria (acute ischemic non-lacunar stroke). Clinical data were collected for each patient, imaging characteristics, and markers of cardiac injury [troponin I (TnI), NT-proBNP, "rise and fall pattern" > 30%]. We compared different stroke subtypes according to OCSP, while evaluating any differences in patients with and without SHS.

Results: In treated total anterior circulation infarct (TACI) patients, the rate of SHS is lower than in non-treated TACI. Similar SHS rate was found in partial anterior (PACI) and posterior stroke (POCI), and between treated and non-treated patients. Focusing on TACI group, we compared SHS-TACI and non-SHS-TACI, we performed a univariate and multivariate analysis; treatment (OR 0.408 CI95% 0.185-0.900; p = 0.026) and diabetes (OR 2.618 CI95% 1.181-5.803; p = 0.018) were significantly associated to SHS. No clear insular effect was found in SHS development.

Conclusions: In severe anterior stroke (TACI), reperfusion treatment may be effective in preventing SHS. Conversely, diabetes is an independent risk factor for SHS. PACI and POCI have similar troponin elevation rate.

Abstract Image

查看原文本刊更多论文

中风性心脏损伤：脑再灌注治疗的效果。一项为期三年的回顾性研究。

背景：急性中风后心脏受累（中风心脏综合征-SHS）是一种公认的并发症，与交感神经激活、炎症和神经内分泌反应有关。肌钙蛋白 "上升和下降模式"> 30% 是脑卒中心脏综合征的标志之一。本研究旨在评估再灌注治疗在不同卒中大小和位置（OCSP 分类）的 SHS 预防/发病机制中的作用：我们对的里雅斯特（意大利）卒中单元在 2018 年至 2020 年期间收治的 890 名患者的数据进行了回顾性分析。其中，411 人符合纳入标准（急性缺血性非湖泊脑卒中）。我们收集了每位患者的临床数据、影像学特征和心脏损伤标志物[肌钙蛋白I（TnI）、NT-proBNP、"上升和下降模式">30%]。我们根据 OCSP 对不同的中风亚型进行了比较，同时评估了有 SHS 和无 SHS 患者的差异：结果：在接受治疗的全前循环梗死（TACI）患者中，SHS 发生率低于未接受治疗的 TACI 患者。部分前循环脑梗死（PACI）和后循环脑梗死（POCI）以及接受治疗和未接受治疗的患者的 SHS 发生率相似。针对 TACI 组，我们比较了 SHS-TACI 和非 SHS-TACI，并进行了单变量和多变量分析；治疗（OR 0.408 CI95% 0.185-0.900; p = 0.026）和糖尿病（OR 2.618 CI95% 1.181-5.803; p = 0.018）与 SHS 显著相关。在SHS的发展过程中未发现明显的岛屿效应：结论：对于严重前脑卒中（TACI），再灌注治疗可有效预防SHS。相反，糖尿病是 SHS 的独立危险因素。PACI和POCI的肌钙蛋白升高率相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.