Latent cardiac dysfunction as assessed by echocardiography in bed-bound patients following cerebrovascular accidents: Comparison with nutritional status

Abstract

The aim of this study was to elucidate the cardiac function in bed-bound patients following cerebrovascular accidents. In accord with the criteria for activities of daily living (ADL) of the Japanese Ministry of Health, Labour and Welfare, 51 age-matched post-stroke patients without heart disease were classified into 3 groups: rank A (house-bound) (n = 16, age, 85 ± 6 years), rank B (chair-bound) (n = 16, age, 84 ± 8 years), and rank C (bed-bound) (n = 19, age, 85 ± 9 years). Using echocardiography, the left ventricular (LV) diastolic function was assessed by the ratio of early filling (E) and atrial contraction (A) transmitral flow velocities (E/A) of LV inflow. LV systolic function was assessed by LV ejection fraction (LVEF), and the Tei index was also measured to assess both LV systolic and diastolic function. No difference was observed in the E/A and LVEF among the 3 groups. The Tei index was higher in rank C (0.56 ± 0.17) than in rank A (0.39 ± 0.06) and rank B (0.48 ± 0.17), and a statistically significant difference was observed between rank A and rank C (P < 0.05). Serum albumin and blood hemoglobin were significantly lower, in rank C (3.1 ± 0.4 and 10.6 ± 1.8 g/ dL) than in rank A (4.1 ± 0.3 and 12.4 ± 1.2 g/dL) (P < 0.001 and P < 0.05, respectively). These results indicate that latent cardiac dysfunction and poor nutritional status may exist in bed-bound patients (rank C) following cerebrovascular accidents. The Tei index may be a useful index of cardiac dysfunction in bed-bound patients because it is independent of the cardiac loading condition.