Evidence map›Paper›PMID 34462469›Full record

ArticleScientific reports2021

Cardiac mechanics and incident ischemic stroke: the Cardiovascular Health Study.

Hooman Kamel, Traci M Bartz, W T Longstreth, Mitchell S V Elkind, John Gottdiener, Jorge R Kizer, Julius M Gardin, Jiwon Kim, Sanjiv Shah

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Subclinical cardiac dysfunction and circulating markers of brain injury in older adults: The cardiovascular health study.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
    Article
  6. Article
  7. Article
  8. Article
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  10. Article
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 1 country.

Hooman KamelClinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, New York, NY, USA. hok9010@med.cornell.edu.
Traci M BartzDepartments of Biostatistics, University of Washington, Seattle, WA, USA.
W T LongstrethDepartments of Neurology, University of Washington, Seattle, WA, USA.
Mitchell S V ElkindDepartment of Neurology, Vagelos College of Physicians and Surgeons, New York, USA.
John GottdienerDivision of Cardiology, University of Maryland, Baltimore, MD, USA.
Jorge R KizerCardiology Section, San Francisco Veterans Affairs Health Care System, and Departments of Medicine, Epidemiology, and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Julius M GardinDivision of Cardiology, Rutgers New Jersey Medical School, Newark, NJ, USA.
Jiwon KimDivision of Cardiology, Weill Cornell Medicine, New York, NY, USA.
Sanjiv ShahDivision of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Seattle University · USWeill Cornell Medicine · USColumbia University · USNorthwestern University · USRutgers, The State University of New Jersey · USSan Francisco VA Medical Center · USUniversity of Maryland, Baltimore · US

Funding

Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5M
CARDIOVASCULAR HEALTH STUDY (CHS) - TASK AREA C, STUDY CLOSEOUT75N92021D00006 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE · 2021 to 2024
$8.4M
CHS research resources for the cardiovascular health of older adultsU01HL130114 · NHLBI · UNIVERSITY OF WASHINGTON · PI BURKE, GREGORY L, KRONMAL, RICHARD A · 2016 to 2019
$6.6M
Transition from Risk Factors to Early HF: Prevalence, Pathogenesis, and PhenomicsR01HL127028 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI BERTONI, ALAIN GERALD, SHAH, SANJIV J · 2015 to 2018
$6.5M
CHS Events Follow-up StudyU01HL080295 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE M · 2005 to 2008
$4.6M
Study of Cardiac Mechanics in Systemic HypertensionR01HL107577 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI SHAH, SANJIV J · 2011 to 2019
$4.1M
MRI Detection of CarotId Plaques as a mecHanism for Embolic strokes of undeteRmined source (MRI DECIPHER)R01HL144541 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI GUPTA, AJAY, KAMEL, HOOMAN · 2019 to 2023
$3.9M
Machine learning for the automated identification and tracking of rare myocardial diseasesR01HL140731 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MACRAE, CALUM A., SHAH, SANJIV J · 2018 to 2021
$2.8M
Role of EIIIA fibronectin in pulmonary fibrosisR01HL085083 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI WHITE, ERIC S · 2007 to 2011
$1.9M
Precision Medicine for Dilated Cardiomyopathy—Novel Assessment of Cardiac Mechanics via Speckle Tracking Echocardiography to Identify Early PhenotypesR01HL149423 · NHLBI · OHIO STATE UNIVERSITY · PI HERSHBERGER, RAY E., KINNAMON, DANIEL DAVIS · 2019 to 2022
$1.6M
Left Atrial abNormality, ThromboEmbolism, and Race: Novel risk factors for stroke (LANTERN)R01NS097443 · NINDS · WEILL MEDICAL COLL OF CORNELL UNIV · PI KAMEL, HOOMAN · 2016 to 2019
$1.5M
Advanced CMR Tissue-Based Prediction of Right Ventricular Dysfunction and Revascularization ResponseK23HL140092 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI KIM, JIWON · 2018 to 2022
$847k
NHLBI NIH HHS 75N92021D00006NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS HHSN268201800001CNHLBI NIH HHS K23 HL140092NHLBI NIH HHS N01HC55222NHLBI NIH HHS N01HC85079NHLBI NIH HHS N01HC85080NHLBI NIH HHS N01HC85081NHLBI NIH HHS N01HC85082NHLBI NIH HHS N01HC85083NHLBI NIH HHS N01HC85086NHLBI NIH HHS R01 HL107577NHLBI NIH HHS R01 HL127028NHLBI NIH HHS R01 HL140731NHLBI NIH HHS R01 HL144541NHLBI NIH HHS R01 HL149423NHLBI NIH HHS U01 HL080295NHLBI NIH HHS U01 HL130114NIA NIH HHS R01 AG023629NINDS NIH HHS R01 NS097443
6 · The paper itself

Abstract

Recent evidence indicates that our understanding of the relationship between cardiac function and ischemic stroke remains incomplete. The Cardiovascular Health Study enrolled community-dwelling adults ≥ 65 years old. We included participants with speckle-tracking data from digitized baseline study echocardiograms. Exposures were left atrial reservoir strain (primary), left ventricular longitudinal strain, left ventricular early diastolic strain rate, septal e' velocity, and lateral e' velocity. The primary outcome was incident ischemic stroke. Cox proportional hazards models were adjusted for demographics, image quality, and risk factors including left ventricular ejection fraction and incident atrial fibrillation. Among 4,000 participants in our analysis, lower (worse) left atrial reservoir strain was associated with incident ischemic stroke (HR per SD absolute decrease, 1.14; 95% CI 1.04-25). All secondary exposure variables were significantly associated with the outcome. Left atrial reservoir strain was associated with cardioembolic stroke (HR per SD absolute decrease, 1.42; 95% CI 1.21-1.67) and cardioembolic stroke related to incident atrial fibrillation (HR per SD absolute decrease, 1.60; 1.32-1.95). Myocardial dysfunction that can ultimately lead to stroke may be identifiable at an early stage. This highlights opportunities to identify cerebrovascular risk earlier and improve stroke prevention via therapies for early myocardial dysfunction.

Indexed as

Stroke VolumeAgedArrhythmias, CardiacAtrial AppendageAtrial FibrillationBrain IschemiaCardiologyEchocardiographyEmbolic StrokeFemaleHeart AtriaHeart VentriclesHumansIschemic StrokeLongitudinal StudiesMale

Identifiers

PMID34462469
PMCPMC8405795
OpenAlexW3196410097

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.