Relationship Between Left Ventricular Wall Motion Abnormalities And Recurrence Of Cerebral Infarction

Purpose:Through the retrospective study and follow-up investigation of patients with cerebral infarction to investigate the correlation between left ventricular wall motion abnormalities and the occurrence and recurrence of cerebral infarction.The mechanism of left ventricular wall motion abnormalities leading to the occurrence and recurrence of cerebral infarction was analyzed.To investigate the risk factors that lead to left ventricular wall motion abnormalities in order to provide more valuable information for the prevention and treatment of cerebral infarction.Method:From January 2013 to December 2014,621 patients with new-onset cerebral infarction hospitalized in the Department of Neurology,the First Affiliated Hospital of Soochow University were included in the case group.All patients met the diagnosis of cerebral infarction established by the Fourth National Cerebrovascular Disease Conference.Standard and confirmed by head CT or cranial MRI.Record the clinical data of patients in the case group such as age,gender,hypertension,diabetes,hyperlipidemia,coronary heart disease,valvular heart disease,atrial fibrillation,and smoking history;Record the laboratory test of total cholesterol,triglyceride,low-density lipoprotein,high-density lipoprotein,and fasting blood glucose in the morning of the next morning after admission;Recording the patient’s imaging data during hospitalization such as head MRA or cervical vascular ultrasound examination and routine electrocardiogram,transthoracic echocardiography,and according to the results of this admission hospital transthoracic echocardiography patients were divided into left ventricular wall motion abnormalities group and non-left ventricular wall motion abnormalities group.TOAST was performed on 621 patients and followed up by telephone.The recurrence of cerebral infarction,death,loss of follow-up,or final follow-up time was the end point,and patients were followed up for oral medication after discharge.200 healthy people from the physical examination center of the First Affiliated Hospital of Soochow University were selected as the control group.The basic data such as sex,age and physical examination data of the healthy control group were collected,such as biochemical indicators and transthoracic echocardiography.Experimental data were analyzed using SPSS17.0 statistical software package.Result:(1)There was no difference in the overall age and gender composition ratio between the case group and the control group.The incidence of left ventricular wall motion abnormalities in the case group was 11.0%,which was much higher than that in the control group(1.5%).The difference was statistically significant.(2)The incidence of hypertension,diabetes,coronary heart disease,atrial fibrillation,valvular heart disease,and cerebro-cerebral vascular stenosis in patients with left ventricular wall motion abnormalities significantly higher than that in non-left ventricular wall motion abnormalities.The difference was statistically significant.The proportion of males and age in patients with left ventricular wall motion abnormalities were significantly higher,and the difference was statistically significant.However,there was no difference in the smoking rate and the incidence of hyperlipidemia between the two groups.(3)Compared with the TOAST classification in the left ventricular wall motion abnormalities group and the non-left ventricular wall motion abnormalities group,the first type of cerebral infarction was large artery atherosclerosis.However,the proportion of cardioembolism in patients with left ventricular wall motion abnormalities was higher than that of non-left ventricular wall motion abnormalities.Whereas the proportion of small vessel occlusion was lower than the non left ventricular wall motion abnormalities group.The composition ratio of the two groups was statistically significant.(4)The recurrence rate of cerebral infarction and mortality rate in patients with left ventricular wall motion abnormalities were higher than those in non-left ventricular wall motion abnormalities.The difference was statistically significant.(5)After adjusting for age,gender,hypertension,diabetes,smoking,atrial fibrillation,valvular heart disease,coronary heart disease,low-density lipoprotein,cervical stenosis,medication treatment after discharge,and other confounding factors.There is still a significant correlation between left ventricular wall motion abnormalities and recurrence of cerebral infarction.Conclusion:1.Left ventricular wall motion abnormalities is more common in patients with cerebral infarction.2.Age,gender,hypertension,diabetes,coronary heart disease,valvular heart disease,atrial fibrillation,and cerebro-cerebral vascular stenosis are related to left ventricular wall motion abnormalities.3.Left ventricular wall motion abnormalities can increases recurrence rate of cerebral infarction and mortality.4.Left ventricular wall motion abnormalities is a risk factor for the recurrence of cerebral infarction.