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{
    "pk": 17981,
    "title": "Impact of Cardiac Contractility during Cerebral Blood Flow in Ischemia",
    "subtitle": null,
    "abstract": "Objective: In cerebral regions affected by ischemia, intrinsic vascular autoregulation is often lost. Blood flow delivery depends upon cardiac function and may be influenced by neuro-endocrine mediated myocardial suppression. Our objective is to evaluate the relation between ejection fraction (EF) and transcranial doppler (TCD) peak systolic velocities (PSV) in patients with cerebral ischemic events.\n\n\nMethods: We conducted a retrospective cohort study from an existing TCD registry. We evaluated patients admitted within 24 hours of onset of a focal neurological deficit who had an echocardiogram and TCD performed within 72 hours of admission.\n\n\nResults: We identified 58 patients from March to October 2003. Eighty-one percent (n=47) had a hospital discharge diagnosis of ischemic stroke and 18.9% (n=11) had a diagnosis of transient ischemic attack. Fourteen patients had systolic dysfunction (EF50%) compared to those with systolic dysfunction (EF<50%) was as follows: middle cerebral artery 62.0 + 28.6 cm/s vs. 51.0 + 23.3 cm/s, p=0.11; anterior cerebral artery 52.1 + 21.6 cm/s vs. 45.9 + 22.7 cm/s, p=0.28; internal carotid artery 56.5 + 20.1 cm/s vs. 46.4 + 18.4 cm/s, p=0.04; ophthalmic artery 18.6 + 7.2 cm/s vs. 15.3 + 5.2 cm/s, p=0.11; vertebral artery 34.0 + 13.9 cm/s vs. 31.6 + 15.0 cm/s, p=0.44.\n\n\nConclusion: Cerebral blood flow in the internal carotid artery territory appears to be higher in cerebral ischemia patients with preserved left ventricular contractility. Our study was unable to differentiate pre-existing cardiac dysfunction from neuro-endocrine mediated myocardial stunning. Future research is necessary to better understand heart-brain interactions in this setting and to further explore the underlying mechanisms and consequences of neuro-endocrine mediated cardiac dysfunction. [West J Emerg Med. 2011;12(2):227-232.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "stroke"
        },
        {
            "word": "Cerebral Vascular Accident"
        },
        {
            "word": "transient ischemic attack"
        },
        {
            "word": "ejection fraction"
        },
        {
            "word": "cerebral blood flow"
        },
        {
            "word": "Neurosciences"
        }
    ],
    "section": "Neurology",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5pf5v0kz",
    "frozenauthors": [
        {
            "first_name": "Charles",
            "middle_name": "R",
            "last_name": "Wira",
            "name_suffix": "",
            "institution": "Yale School of Medicine, New Haven, CT",
            "department": "None"
        },
        {
            "first_name": "Emanuel",
            "middle_name": "",
            "last_name": "Rivers",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Detroit, MI",
            "department": "None"
        },
        {
            "first_name": "Brian",
            "middle_name": "",
            "last_name": "Silver",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Detroit, MI",
            "department": "None"
        },
        {
            "first_name": "Christopher",
            "middle_name": "",
            "last_name": "Lewandowski",
            "name_suffix": "",
            "institution": "Henry Ford Hospital, Detroit, MI",
            "department": "None"
        }
    ],
    "date_submitted": "2009-08-31T07:00:00Z",
    "date_accepted": "2009-08-31T07:00:00Z",
    "date_published": "2011-03-23T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/17981/galley/9181/download/"
        }
    ]
}