Evaluation of Neurogenic Myocardial Stunning by TwoDimensional Speckle Tracking Echocardiography
Cigdem Ileri1, Emre Eynel2, Zekeriya Dogan3, Beste Ozben3, Nevin Pazarci41Department of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Türkiye, 2Department of Cardiology, Umraniye Training and Research Hospital, Istanbul, Türkiye, 3Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Türkiye, 4Department of Neurology, Umraniye Training and Research Hospital, Istanbul, Türkiye
Objectives: Neurogenic stunned myocardium (NSM) is a cardiac condition resulting from acute neurological events that can lead to a reduction in myocardial strain, an important parameter used to assess cardiac function. The aim of our study was to investigate the NSM and its impact on myocardial strain. Methods: 82 consecutive patients (mean age: 66 ±14 years, 36 male) presenting with acute ischemic stroke were consecutively included. LV functions of all patients were evaluated by two-dimensional (2D) speckle-tracking echocardiography. High-sensitive cardiac Troponin I (hs-cTnI) level>0.04ng/mL was accepted as increased. Results: 33 patients (40.2%) had elevated hs-cTnI and 23 patients (28%) had insular cortex involvement. The stroke patients with elevated hs-cTnI had higher frequencies of coronary artery disease and insular cortex involvement, higher NT-proBNP levels, and lower left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), global and regional circumferential strain compared to patients with normal troponin levels. Although the patients with insular cortex involvement had significantly higher hs-cTnI levels, there were not any significant differences in LVEF and 2D-STE parameters between the groups. Conclusion: Elevated troponin levels may be associated with a decrease in LVEF and myocardial strain parameters, especially in acute ischemic stroke patients with insular cortex involvement; and may be considered as a sign of neurogenic myocardial stunning. Keywords: Acute ischemic stroke; myocardial stunning; neurogenic cardiac injury; troponin
Cite This Article
Ileri C, Eynel E, Dogan Z, Ozben B, Pazarci N. Evaluation of Neurogenic Myocardial Stunning by TwoDimensional Speckle Tracking Echocardiography. EJMI. 2023; 7(3): 334-339
Corresponding Author: Cigdem Ileri