Einfluss der Herzinsuffizienz auf das Outcome nach Thrombektomie bei Schlaganfallpatienten

Impact of heart failure on outcome after thrombectomy in stroke patients

by Anneki Baronin von Hahn née von Glasenapp
Doctoral thesis
Date of Examination:2023-09-20
Date of issue:2023-09-12
Advisor:Prof. Dr. Jan Liman
Referee:Prof. Dr. Jan Liman
Referee:Prof. Dr. Marco Schroeter
Persistent Address: http://dx.doi.org/10.53846/goediss-10091

 

 

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Abstract

English

There are studies that indicate that heart failure has an impact on the mortality and morbidity of stroke patients. But this influence of heart failure on stroke outcome has not yet been established. We asked ourselves to what extent heart failure has an influence on the outcome of large vessel occlusion in the anterior circulation after mechanical thrombectomy compared with patients without heart failure. We retrospectively analyzed the echocardiographic data of our patients enrolled in the Göttinger Thrombectomy Registry (n = 668), for heart failure and other abnormal echocardiographic pathologies. Most of the patients underwent mechanical thrombectomy. Furthermore, we collected neurological and neuroradiological parameters of the stroke patients. Of the 668 patients in the Göttinger Thrombectomy Registry, 373 patients (n = 373) received an echocardiographic examination and only these got included. Of these 373 patients, 90 patients (24%) suffered from heart failure with reduced left ventricular ejection fraction measured by echocardiography. Including age, ASPECTS and time between symptom onset and vessel recanalization, we found out that mechanical thrombectomy in patients with heart failure did not result in a worse outcome as measured by the modified Rankin Scale (mRS) 90 days after therapy than patients without heart failure (3 (1 - 5) vs. 3 (1 - 5); p = 0.380). Furthermore, in our study, we did not demonstrate increased mortality in stroke patients with present heart failure (11.0% vs. 7.4%; p = 0.313). However, it should be mentioned that in our study, reduced left ventricular ejection fraction was used as an inclusion criterion in the patient group with heart failure. This results in the patients with heart failure with preserved ejection fraction or diastolic heart failure in our study being in the group of patients without heart failure.
Keywords: stroke; heart failure; thrombectomy; outcome
 
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