ArticleStroke and vascular neurology2023
Acute right insular ischaemic lesions and poststroke left ventricular dysfunction.
Article in Stroke and vascular neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 21 citations in OpenAlex.
- Neurocardiology: Brain-Heart Interactions in the Heart.MedComm · 2026Review
- Insights into the pathophysiology of stroke-heart syndrome: a review of recent literature and clinical trials to illuminate promising therapeutic strategies.Annals of medicine and surgery (2012) · 2026Article
- Bidirectional brain-heart interactions in health and disease.Nature reviews. Neurology · 2026Review
- Heart-Brain Axis: Subclinical Cardiovascular Changes and Brain Health.Journal of the American Heart Association · 2026Review
- Brain heart crosstalk after ischemic stroke toward a unified framework for pathophysiology and precision medicine.Frontiers in molecular neuroscience · 2026Review
- Central autonomic network dysfunction in Stroke-Heart Syndrome: mechanistic roles of the insula and limbic system.Frontiers in neuroscience · 2026Review
- Lesion Network Mapping for Atrial Fibrillation Newly Detected on ECG or Cardiac Monitoring After Stroke.Journal of the American Heart Association · 2025Article
- The heart-brain crosstalk in age related cardiovascular and neurodegenerative diseases.Fluids and barriers of the CNS · 2025Review
- Autonomic dysfunction after stroke: an overview of recent clinical evidence and perspectives on therapeutic management.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Review
- Early Risk Prediction Model for Stroke-Heart Syndrome Following Endovascular Therapy.Aging and disease · 2025Article
- The brain-heart axis: integrative cooperation of neural, mechanical and biochemical pathways.Nature reviews. Cardiology · 2025Review
- Unravelling the role of electrocardiogram changes and ejection fraction in ischaemic stroke outcomes.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025Review
- The Heart-Brain Axis: Key Concepts in Neurocardiology.Cardiology discovery · 2025Review
- Cardiac Events After Mechanical Thrombectomy in Acute Ischemic Stroke: A Nation-Wide Cohort Study.European journal of neurology · 2025Article
- Motor induced syncope after cerebral infarction: A case report and literature review.SAGE open medical case reports · 2025Article
- The Hidden Heart: Exploring Cardiac Damage Post-Stroke: A Narrative Review.Medicina (Kaunas, Lithuania) · 2024Review
- Cardiac Findings Following Cerebrovascular Disease.Journal of the American Heart Association · 2024Article
- Stroke heart injury: the effect of cerebral reperfusion treatment. A 3-year retrospective study.Journal of neurology · 2024Article
- Stroke-heart syndrome: current progress and future outlook.Journal of neurology · 2024Review
- Ischemic insular damage and stress ulcer in patients of acute ischemic stroke.Brain and behavior · 2024Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMyocardial injury related to acute ischaemic stroke is common even without primary cardiac disease. We intended to determine associations between values of left ventricular ejection fraction (LVEF) and ischaemic stroke lesion sites.
methodsOf a local database, patients with acute first-ever ischaemic stroke confirmed by brain imaging but without pre-existing heart disease were included. The cardiac morphology and LVEF were obtained from transthoracic or transesophageal echocardiography, and impaired LVEF was categorised as mild (35%-50%), moderate (34%-25%) and severe (<25%). Patient age, stroke severity, ischaemic lesion volume, prevalence of troponin I increase (>0.1 ng/mL), atrial fibrillation and cardiac wall motion abnormalities were assessed and compared between patients with and without impaired LVEF after stroke (significance: p<0.05). A multivariate voxelwise lesion analysis correlated LVEF after stroke with sites of ischaemic lesions.
resultsOf 1209 patients who had a stroke, 231 (mean age 66.3±14.0 years) met the inclusion criteria; 40 patients (17.3%) had an impaired LVEF after stroke. Patients with impaired LVEF had higher infarct volumes (53.8 mL vs 30.0 mL, p=0.042), a higher prevalence of troponin increase (17.5% vs 4.2%, p=0.006), cardiac wall motion abnormalities (42.5% vs 5.2%, p<0.001) and atrial fibrillation (60.0% vs 26.2%, p<0.001) than patients with LVEF of >50%. The multivariate voxelwise lesion analysis yielded associations between decreased LVEF and damaged voxels in the insula, amygdala and operculum of the right hemisphere.
conclusionOur imaging analysis unveils a prominent role of the right hemispheric central autonomic network, especially of the insular cortex, in the brain-heart axis. Our results support preliminary evidence that acute ischaemic stroke in distinct brain regions of the central autonomic network may directly impair cardiac function and thus further supports the concept of a distinct stroke-heart syndrome.
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