Diastolic function in young patients with cryptogenic stroke : A case-control pilot study

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Pirinen, J, Kuusisto, J, Järvinen, V, Martinez-Majander, N, Sinisalo, J, Pöyhönen, P & Putaala, J 2020, ' Diastolic function in young patients with cryptogenic stroke : A case-control pilot study ', Clinical Physiology and Functional Imaging, vol. 40, no. 5, pp. 336-342 . https://doi.org/10.1111/cpf.12640

Title: Diastolic function in young patients with cryptogenic stroke : A case-control pilot study
Author: Pirinen, Jani; Kuusisto, Jouni; Järvinen, Vesa; Martinez-Majander, Nicolas; Sinisalo, Juha; Pöyhönen, Pauli; Putaala, Jukka
Contributor organization: HUS Medical Imaging Center
HUS Neurocenter
Department of Diagnostics and Therapeutics
University of Helsinki
Helsinki University Hospital Area
HUS Heart and Lung Center
Department of Neurosciences
Department of Medicine
Date: 2020-09
Language: eng
Number of pages: 7
Belongs to series: Clinical Physiology and Functional Imaging
ISSN: 1475-0961
DOI: https://doi.org/10.1111/cpf.12640
URI: http://hdl.handle.net/10138/318845
Abstract: Background Ischaemic stroke in young individuals often remains cryptogenic. In this pilot study, we investigated, whether advanced echocardiography methods could find differences in the diastolic function between young cryptogenic stroke patients and stroke-free controls. Methods We recruited 30 cryptogenic ischaemic stroke patients aged 18-49 and 30 age- and sex-matched stroke-free controls among participants of the Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO) study (NCT01934725). We measured diastolic function parameters derived from speckle tracking strain rate, Doppler techniques and 4D volumetry. We also performed statistical analyses comparing only the highest and lowest tertile of cases and controls for each parameter. Results None of our patients or controls had diastolic dysfunction according to ASE/EACVI criteria. However, compared to stroke-free controls, the stroke patient group had lower E/A ratio of mitral inflow, lower lateral and mean e', lower A/a' ratio, lower strain rate in early diastole and lower speckle tracking-derived e/a ratio. When comparing the lowest tertiles, patients also had a lower peak filling rate by 4D volumetry, a lower peak early filling fraction (fraction of left ventricular filling during early diastole), and lower velocities in a series of the tissue Doppler-derived diastolic parameters and blood flow/tissue velocity ratios. Conclusion Our study displayed subtle differences in diastolic function between patients and stroke-free controls, which may play a role in early-onset cryptogenic stroke. The differences were clearer when the lowest tertiles were compared, suggesting that there is a subgroup of young cryptogenic stroke patients with subclinical heart disease.
Subject: 4D volumetry
brain infarction
strain imaging
strain rate imaging
1184 Genetics, developmental biology, physiology
3112 Neurosciences
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: acceptedVersion

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