Cardiac diastolic dysfunction predicts in-hospital mortality in acute ischemic stroke with atrial fibrillation

• We assessed diastolic dysfunction in ischemic stroke with AF.
• We defined diastolic dysfunction as a high E/e′ on transthoracic echocardiography.
• High E/e′ predicted in-hospital death in ischemic stroke patients with AF.

BackgroundThe aim of this study was to identify whether diastolic dysfunction predicts in-hospital death in ischemic stroke patients with atrial fibrillation.MethodWe retrospectively analyzed data from enrolled patients with ischemic stroke patients with atrial fibrillation who presented within 24 h of onset. All patients underwent transthoracic echocardiography to evaluate diastolic filling pressure estimated as the ratio of early transmitral flow velocity (E) to mitral annular velocity (e′) within 24 h of admission. We evaluated initial ischemic lesion volume and National Institute of Health Stroke Scale (NIHSS) score.ResultsTwo hundred and sixty-six patients were enrolled. During hospitalization, 30 patients (11%) died. The deceased group had a higher NIHSS score, a higher D-dimer level, a higher creatinine level, a larger initial ischemic lesion volume and a higher E/e′ ratio than those in the survival group. In a multivariate analysis, a higher E/e′ ratio was an independent predictor of in-hospital death. The cutoff value for the E/e′ ratio for prediction in-hospital death was 20 with the sensitivity of 75% and specificity of 86%.ConclusionDiastolic dysfunction may be associated with in-hospital death in ischemic stroke patients with atrial fibrillation.