Abstract Details

Title Echocardiographic Abnormalities and Determinants of 1-month Outcome of Stroke Among West Africans in the SIREN Study

Topic General Neurology

Presentation(s) S57 - General Neurology: Diagnostic Testing and Disease Biomarkers (4:06 PM-4:18 PM)

Poster/Presentation
Number 004

Objective We investigated the pattern and association of baseline echocardiographic variables with 1-month disability and mortality among patients with stroke in the SIREN study.

Background Certain transthoracic echocardiography features such as left atrial volume, spontaneous echo contrast or “smoke,” increased left ventricular (LV) mass, and poor LV functions have been previously associated with stroke and stroke outcome. Despite the aforementioned, the current recommendations for the management of acute stroke does not consider echocardiography as an essential test in patients with stroke. As a result, little is known about the relationship between echocardiographic abnormalities and outcome among patients with acute stroke.

Design/Methods The SIREN study is a multicenter case-control investigation that involves 15 sites in Ghana and Nigeria. We enrolled and followed up consecutive 1020 adult patients with acute stroke with baseline transthoracic echocardiography from West Africa. To explore the relationship between echocardiographic variables and 1-month disability (using modified Rankin scale >3) and fatality, regression models were fitted. Relative risks were computed with 95% Cis.

Results

The participants comprised 60% men with a mean age of 59.2±14.6 years. Ischemic stroke was associated with smaller aortic root diameter (30.2 versus 32.5, P=0.018) and septal (16.8 versus 19.1, P<0.001) and posterior wall thickness at systole (18.9 versus 21.5, P=0.004). Over 90% of patients with stroke had abnormal left ventricular (LV) geometry with eccentric hypertrophy predominating (56.1%). Of 13 candidate variables investigated, only baseline abnormal LV geometry (concentric hypertrophy) was weakly associated with 1-month disability (unadjusted relative risk, 1.80; 95% CI , 0.97-5.73). Severe LV systolic dysfunction (SD) was significantly associated with increased 1-month mortality (unadjusted relative risk, 3.05; 95% CI , 1.36-6.83).

Conclusions 9/10 patients with acute stroke had abnormal LV geometry and 1/3 had SD. This was significantly associated with 1 month mortality. Larger studies are required to establish the independent effect and unravel predictive accuracy of this association.

Authors/Disclosures
Mayowa Owolabi, MD, FAAN (Neurology Unit, Dept of Med, UCH) PRESENTER	Dr. Owolabi has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Rufus O. Akinyemi, MD (Institute for Advanced Medical Research and Training)	Dr. Akinyemi has nothing to disclose.
	No disclosure on file
Kolawole W. Wahab, MD, FAAN (University of Ilorin Teaching Hospital)	Dr. Wahab has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Hemant Tiwari	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Fred Sarfo	Fred Sarfo has nothing to disclose.
Albert K. Akpalu, MD (School of Medicine and Dentistry)	Dr. Akpalu has nothing to disclose.
	No disclosure on file
Daniel T. Lackland, PhD (Medical University of South Carolina)	An immediate family member of Prof. Lackland has received personal compensation for serving as an employee of Sound Pharmacetical. Prof. Lackland has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley Publishing. Prof. Lackland has received publishing royalties from a publication relating to health care.
Lukman F. Owolabi, PhD, MSc, FWAPC, FMCP (Bayero University)	Dr. Owolabi has nothing to disclose.
Morenikeji Komolafe, MD (Obafemi Awolowo University)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Bruce I. Ovbiagele, MD, MSc, FAAN (San Francisco VA)	Dr. Ovbiagele has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Stroke Association. Dr. Ovbiagele has received research support from National Institutes of Health. Dr. Ovbiagele has a non-compensated relationship as a President with Society for Equity Neuroscience that is relevant to AAN interests or activities. Dr. Ovbiagele has a non-compensated relationship as a Board Member with World Stroke Organization that is relevant to AAN interests or activities.

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