Deans' stroke musings: EXPRESS: Elevation of cardiac biomarkers in stroke is associated with pathological findings on cardiac MRI

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, April 13, 2022

EXPRESS: Elevation of cardiac biomarkers in stroke is associated with pathological findings on cardiac MRI - results of the HEBRAS study

You'll have to hope your stroke hospital has a protocol on testing for this post stroke. Good luck with that.

EXPRESS: Elevation of cardiac biomarkers in stroke is associated with pathological findings on cardiac MRI - results of the HEBRAS study

. 2022 Apr 11;17474930221095698.

doi: 10.1177/17474930221095698. Online ahead of print.

Regina Irene Freiin von Rennenberg^{1

2

3}, Juliane Herm^{4

2}, Thomas Krause⁵, Simon Hellwig^{6

2}, Helena Stengl^{6

2}, Jan F Scheitz^{7

2

8}, Thomas Elgeti⁹, Sebastian Nagel⁹, Matthias Endres^{6

2

10

8

11}, Karl Georg Häusler¹², Christian H Nolte^{6

2

3

8}

Affiliations

PMID: 35403503
DOI: 10.1177/17474930221095698

Abstract

Introduction

Cardiac biomarkers, such as high-sensitivity cardiac troponin T (hs-cTnT), are frequently elevated in ischemic stroke patients but the mechanisms underlying this elevation are insufficiently understood. We determined the presence of cardiac damage, assessed using cardiac MRI (CMR), in stroke patients with elevated hs-cTnT and brain natriuretic peptide (BNP).MethodsThis is a post-hoc analysis of the prospective, investigator-initiated, cross-sectional HEBRAS (HEart and BRain interfaces in Acute Stroke) study. All patients underwent measurement of hs-cTnT and BNP as well as gadolinium-enhanced CMR in the acute phase of ischemic stroke. We performed unadjusted and adjusted logistic regression models to assess the association between hs-cTnT and BNP elevation and the presence of pathological CMR findings.ResultsTwo hundred and thirty three stroke patients (median age 67 years, 33% female) were included, of whom 43 (21%) had elevated hs-cTnT and 109 (47%) had elevated BNP. 100 of the 233 (43%) patients had pathological findings on CMR had focal fibrosis as detected by late-gadolinium enhancement (LGE) in 51 (23%), left-ventricular hypertrophy (LVH) in 38 (16%), reduced LVEF in 32 (14%) and left atrial dilatation in 34 (15%). After adjustment for potential confounders, both hs-cTnT (adjOR 5.0 (95%CI 2.1-11.7), p<0.001) and BNP (adjOR 4.1 (95%CI 2.3-7.3), p<0.001) were significantly associated with pathological findings on CMR. Hs-cTnT was associated with LGE, LVEF and LVH, whereas BNP was associated with left atrial dilatation and LVEF, LVH.ConclusionElevated cardiac biomarkers in acute stroke including CMR are strongly associated with pathological findings on CMR. In acute stroke patients, elevation of cardiac biomarkers may identify patients who require a more thorough cardiology work-up.

Keywords: Risk factors; cardiovascular MRI; heart and brain axis; mild ischemic stroke; natriuretic peptides; troponin.