To evaluate the association between cardiovascular function and 90-day outcomes in patients with primary intracerebral hemorrhage (ICH).

Spontaneous, non-traumatic ICH is a devastating stroke subtype associated with high morbidity and mortality. Risk factors for ischemic and hemorrhagic stroke overlap with those of cardiovascular disease. Some indices of cardiovascular (CV) function such as left ventricular mass index (LVMI) and ejection fraction (LVEF) influence long-term functional outcomes in ischemic stroke patients treated with reperfusion therapies.

A retrospective review was conducted on all consecutive patients presenting with ICH from 2017 to 2019. Only patients with primary ICH were included. Patient demographics, clinical characteristics and 90-day modified Rankin Score (mRS) were obtained from the Houston Methodist Hospital Outcomes Based Prospective Endpoints in Stroke (HOPES) registry and echocardiogram parameters were collected. We compared patients with good functional outcomes (defined as mRS 0-2) versus bad (mRS 3-6).

Overall, 101 patients were included (mean age 64.8y [SD 15.75], 53.5% male). Demographics and hematoma location were similar in both groups. A good functional outcome was achieved in 34.7% of patients. The median ICH score was 0 and 2 in patients with good and bad functional outcomes, respectively. On multivariate logistic regression analysis, controlling for ICH scores, left atrial enlargement was associated with higher odds of bad functional outcomes (OR 2.23, [95%CI [1.04-4.80]; p=0.038). An abnormal left atrial systolic diameter (>3.8 cm in females and >4.0 cm in males) was also associated with bad functional outcomes (OR 4.72, 95%CI [1.36-16.32]; p=0.014). Patients with moderate to severely abnormal LVMI (>108 g/m² in females and >131 g/m² in males) were also more likely to have bad functional outcomes, compared to those with normal to mildly abnormal LVMI (OR 3.54, 95%CI [1.08-11.72]; p=0.038).

Echocardiogram indices of cardiovascular function can serve as predictors of functional outcomes in patients with primary ICH.