TY - JOUR T1 - Left ventricular systolic dysfunction is associated with poor functional outcomes after endovascular thrombectomy JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 515 LP - 518 DO - 10.1136/neurintsurg-2020-016216 VL - 13 IS - 6 AU - Benjamin Y Q Tan AU - Aloysius ST Leow AU - Tsong-Hai Lee AU - Vamsi Krishna Gontu AU - Tommy Andersson AU - Staffan Holmin AU - Ho-Fai Wong AU - Chuan-Min Lin AU - Chih-Kuang Cheng AU - Ching-Hui Sia AU - Nicholas Ngiam AU - Zhi-Xuan Ng AU - Joshua Yeo AU - Bernard Chan AU - Hock-Luen Teoh AU - Raymond Seet AU - Prakash Paliwal AU - Gopinathan Anil AU - Cunli Yang AU - Volker Maus AU - Nuran Abdullayev AU - Anastasios Mpotsaris AU - Pervinder Bhogal AU - Ken Wong AU - Hegoda Levansri Dilrukshan Makalanda AU - Oliver Spooner AU - Sageet Amlani AU - Daniel Campbell AU - Robert Michael AU - Ulf Quäschling AU - Stefan Schob AU - Jens Maybaum AU - Vijay Kumar Sharma AU - Leonard LL Yeo Y1 - 2021/06/01 UR - http://jnis.bmj.com/content/13/6/515.abstract N2 - 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. ER -