Association between reduced left ventricular ejection fraction and functional outcomes in acute stroke: Systematic review and meta-analysis

Introduction: Left ventricular ejection fraction (LVEF) is a measure of cardiac function and often reduced LVEF is indicative of cardiomyopathy/heart failure. The current study evaluated whether reduced LVEF is associated with poor outcomes and mortality in acute stroke.

Methods: Articles that compared poor outcomes (modified Rankin scale 3-6) or mortality in people with reduced LVEF compared to preserved LVEF in acute ischemic stroke were searched in the following databases: MEDLINE/PubMed, Embase, Scopus, Biomed central, and Cochrane Library. The last search was on March 17, 2024. The results obtained were pooled in meta-analyses.

Results: A total of 28933 participants were enrolled from 17 articles. Reduced left ventricular ejection fraction was independently associated with poor outcomes at 90 days (OR:2.38 CI95 % 1.52;3.71; I² = 71 %), the same was observed for death at 90 days (OR:3.15 CI 95 % 1.43; 6.96; I² = 60 %).

Conclusion: Reduced LVEF is associated with poor functional outcomes and death within 3 months after acute ischemic stroke compared to the setting in which LVEF is preserved.