Characterisation of age related changes in left heart structure and function in young patients with ischaemic stroke

Abstract

BACKGROUND: A significant proportion of strokes in the young are cryptogenic and presumed to be embolic. Our group have recently demonstrated subclinical alterations in left atrial (LA) function in young patients with stroke. The AIM of our current study was to gain mechanistic insights into the pathophysiology of stroke in this population by characterising the age-related changes in cardiac structure and function. METHOD(s): Patients aged <65 years with ischaemic stroke admitted into a stroke unit between Jan 2013 and Dec 2016 and a comprehensive transthoracic echocardiogram were included. Patients were divided into three groups, based on equal tertiles of age and a range of clinical and echocardiographic parameters examined. All echocardiographic parameters were measured according to recommended guidelines. Patients with congenital or valvular heart disease were excluded. RESULT(s): Of a total of 140 patients (52.00+/-9.99yrs, 61% ) included, 46% had hypertension, 30% diabetes mellitus and 29% hypercholesterolaemia. Left ventricular (LV) mass increased with age (p<0.01) which was associated with a parallel increase in A velocity, decrease in E/A ratio and increase in E/e'. The LA volume index did not change significantly over the first two tertiles (p=1.00) but increased significantly from the second to third age tertile (p=0.05). Of interest, LA min volumes (p<0.01) increased significantly over the three tertiles, although this did not significantly impact on LA ejection fraction (LAEF). No changes in LV volumes or LVEF were observed. See Table 1. CONCLUSION(s): Our study identified changes in left heart structure and function in the young stroke population.