ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
A Novel Approach to Assessing the Severity of Acute Stroke and Neurological Deficits in Patients with Acute Ischemic Stroke Using Myocardial Work Echocardiography [Anatol J Cardiol]
Anatol J Cardiol. 2022; 26(12): 893-901 | DOI: 10.5152/AnatolJCardiol.2022.1769

A Novel Approach to Assessing the Severity of Acute Stroke and Neurological Deficits in Patients with Acute Ischemic Stroke Using Myocardial Work Echocardiography

Jun Zhang1, Xu-Chu Wu2, Xiao-zhi Zheng2
1Department of Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Jiangsu, People’s Republic of China
2Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China

Background: We aimed to evaluate the feasibility and performance of myocardial work echocardiography in assessing the severity of acute stroke and neurological deficits in patients with acute ischemic stroke.

Methods: A total of 176 patients were examined by echocardiography within 24-48 hours of symptom onset with the measurement of global and regional myocardial work. The National Institutes of Health Stroke Scale score of each patient was documented.

Results: With the increase of the National Institutes of Health Stroke Scale score, myocardial constructive work or positive work decreased (P <.05), while myocardial wasted work or negative work increased (P <.05). Except for global constructive work, global positive work, and global systolic constructive work, other myocardial work parameters all correlated with the National Institutes of Health Stroke Scale score
(P  < .05). Moreover, global wasted work, global negative work and global systolic wasted work had the strongest correlation with the National Institutes of Health Stroke Scale score (P  < .001).Among these parameters, the ratio of global positive work/global negative work had the largest area (0.969, 0.938-1.001) under receiver operating characteristic curve in discriminating if the National Institutes of Health Stroke Scale score >15 or not. The optimal cutoff value was 3.89, with a sensitivity of 100%, a specificity of 93.0%, a positive predictive value of 84.9%, a negative predictive value of 100%, and an accuracy of 95.7%.

Conclusion: Noninvasive myocardial work is highly competent in assessing the severity of acute stroke and neurological deficits, which can be used as a powerful supplement to the conventional scoring system.

Keywords: Stroke, neurological deficits, NIHSS score, myocardial damage, myocardial work echocardiography

Jun Zhang, Xu-Chu Wu, Xiao-zhi Zheng. A Novel Approach to Assessing the Severity of Acute Stroke and Neurological Deficits in Patients with Acute Ischemic Stroke Using Myocardial Work Echocardiography. Anatol J Cardiol. 2022; 26(12): 893-901

Corresponding Author: Jun Zhang
Manuscript Language: English


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