@article {Tan515, author = {Benjamin Y Q Tan and Aloysius ST Leow and Tsong-Hai Lee and Vamsi Krishna Gontu and Tommy Andersson and Staffan Holmin and Ho-Fai Wong and Chuan-Min Lin and Chih-Kuang Cheng and Ching-Hui Sia and Nicholas Ngiam and Zhi-Xuan Ng and Joshua Yeo and Bernard Chan and Hock-Luen Teoh and Raymond Seet and Prakash Paliwal and Gopinathan Anil and Cunli Yang and Volker Maus and Nuran Abdullayev and Anastasios Mpotsaris and Pervinder Bhogal and Ken Wong and Hegoda Levansri Dilrukshan Makalanda and Oliver Spooner and Sageet Amlani and Daniel Campbell and Robert Michael and Ulf Qu{\"a}schling and Stefan Schob and Jens Maybaum and Vijay Kumar Sharma and Leonard LL Yeo}, title = {Left ventricular systolic dysfunction is associated with poor functional outcomes after endovascular thrombectomy}, volume = {13}, number = {6}, pages = {515--518}, year = {2021}, doi = {10.1136/neurintsurg-2020-016216}, publisher = {British Medical Journal Publishing Group}, abstract = {Background Endovascular thrombectomy (ET) has transformed acute ischemic stroke (AIS) therapy in patients with large vessel occlusion (LVO). Left ventricular systolic dysfunction (LVSD) decreases global cerebral blood flow and predisposes to hypoperfusion. We evaluated the relationship between LVSD, as measured by LV ejection fraction (LVEF), and clinical outcomes in patients with anterior cerebral circulation LVO who underwent ET.Methods This multicenter retrospective cohort study examined anterior circulation LVO AIS patients from six international stroke centers. LVSD was measured by assessment of the echocardiographic LVEF using Simpson{\textquoteright}s biplane method of discs according to international guidelines. LVSD was defined as LVEF \<50\%. The primary outcome was defined as a good functional outcome using a modified Rankin Scale (mRS) of 0{\textendash}2 at 3 months.Results We included 440 AIS patients with LVO who underwent ET. On multivariate analyses, pre-existing diabetes mellitus (OR 2.05, 95\% CI 1.24 to 3.39;p=0.005), unsuccessful reperfusion (Treatment in Cerebral Infarction (TICI) grade 0-2a) status (OR 4.21, 95\% CI 2.04 to 8.66; p\<0.001) and LVSD (OR 2.08, 95\% CI 1.18 to 3.68; p=0.011) were independent predictors of poor functional outcomes at 3 months. On ordinal (shift) analyses, LVSD was associated with an unfavorable shift in the mRS outcomes (OR 2.32, 95\% CI 1.52 to 3.53; p\<0.001) after adjusting for age and ischemic heart disease.Conclusion Anterior circulation LVO AIS patients with LVSD have poorer outcomes after ET, suggesting the need to consider cardiac factors for ET, the degree of monitoring and prognostication post-procedure.Data relevant to the study are included in the article or uploaded as supplementary information. Additional data is available on email request.}, issn = {1759-8478}, URL = {https://jnis.bmj.com/content/13/6/515}, eprint = {https://jnis.bmj.com/content/13/6/515.full.pdf}, journal = {Journal of NeuroInterventional Surgery} }