Echocardiographic abnormalities in patients with stroke during the subacute rehabilitation phase
Masahiro Tsujikawa , Yohei Otaka, Rei Hasegawa, Kunitsugu Kondo , Meigen Liu
Department of Rehabilitation Medicine, Keio University School of Medicine, Japan
Objective: To evaluate cardiac function using echocardiography in patients with stroke admitted to subacute rehabilitation units.
Design: Retrospective, cross-sectional study.
Participants: A total of 750 consecutive patients with stroke who were admitted to a suburban rehabilitation hospital. Mean age 67.5 years (standard deviation (SD) 12.3 years). Mean time since stroke 36.7 days (SD 13.2 days).
Methods: Patients were assessed using transthoracic echocardiography within 7 days of admission. The prevalence of echocardiographic abnormalities was analysed and compared between cerebral infarction and haemorrhage using the Mantel-Haenszel method controlled for age.
Results: Arrhythmias were found in 13.7% of the patients, 94.2% of whom had atrial fibrillation. Left atrial enlargement and left ventricular hypertrophy were found in 20.4% and 19.5% of all patients, respectively. Left ventricular asynergy was detected in 6.1% of all patients, but 47.8% of them had no history of myocardial infarction. Left ventricular ejection fraction was low in 12.2% of all patients. Abnormal rhythms and left atrial enlargement were significantly more frequent in patients with cerebral infarction than in those with cerebral haemorrhage (p < 0.01).
Conclusion: The prevalence of cardiac problems is high among patients with subacute stroke regardless of a history of heart disease, and this should be taken into account when planning rehabilitation programmes.
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