%0 Journal Article %A Benjamin Y Q Tan %A Aloysius ST Leow %A Tsong-Hai Lee %A Vamsi Krishna Gontu %A Tommy Andersson %A Staffan Holmin %A Ho-Fai Wong %A Chuan-Min Lin %A Chih-Kuang Cheng %A Ching-Hui Sia %A Nicholas Ngiam %A Zhi-Xuan Ng %A Joshua Yeo %A Bernard Chan %A Hock-Luen Teoh %A Raymond Seet %A Prakash Paliwal %A Gopinathan Anil %A Cunli Yang %A Volker Maus %A Nuran Abdullayev %A Anastasios Mpotsaris %A Pervinder Bhogal %A Ken Wong %A Hegoda Levansri Dilrukshan Makalanda %A Oliver Spooner %A Sageet Amlani %A Daniel Campbell %A Robert Michael %A Ulf Quäschling %A Stefan Schob %A Jens Maybaum %A Vijay Kumar Sharma %A Leonard LL Yeo %T Left ventricular systolic dysfunction is associated with poor functional outcomes after endovascular thrombectomy %D 2021 %R 10.1136/neurintsurg-2020-016216 %J Journal of NeuroInterventional Surgery %P 515-518 %V 13 %N 6 %X 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’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 0–2 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. %U https://jnis.bmj.com/content/neurintsurg/13/6/515.full.pdf