Acute Coronary Syndromes, Arrhythmia, Heart Failure, Heart Rate Variability, Myocardial Injury, Stroke, Sudden Cardiac Death, Takotsubo Syndrome
Conditions
Keywords
Stroke-heart syndrome
Brief summary
The incidence of stroke-heart syndrome following acute stroke, which encompasses both acute ischemic stroke and acute intracerebral hemorrhage, is notably high and is strongly associated with increased mortality and poor outcomes in stroke patients. However, the underlying mechanisms remain unclear, and there are currently no effective prevention or treatment strategies. This study aims to elucidate the neuro-humoral mechanisms of stroke-heart syndrome through multimodal imaging and multi-omics blood analysis. Additionally, it seeks to observe the progression of stroke-heart syndrome and its impact on functional outcomes, cognitive abilities, and emotional issues post-stroke. The research is expected to uncover novel blood biomarkers and brain network mechanisms associated with stroke-heart syndrome, providing potential targets and theoretical foundations for pharmacological treatments or physical interventions. Furthermore, it aims to establish a risk early-warning system for major cardiovascular complications post-stroke, enabling early identification, early intervention, and integrated brain-heart management to improve clinical outcomes for stroke patients.
Interventions
None listed
Sponsors
National Natural Science Foundation of China
Chensheng Pan
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients admitted within 48 hours of onset, confirmed by CT/MRI as having a stroke (including acute ischemic stroke and hemorrhagic stroke). 2. Moderate-to-severe stroke with NIHSS ≥ 5.
Exclusion criteria
1. Previous focal brain injury (such as stroke, brain surgery, traumatic brain injury, etc.). 2. Brain dysfunction caused by other major neurological disorders than stroke (such as brain tumors, epilepsy, Parkinson's disease, etc.). 3. Transient ischemic attack (TIA) and subarachnoid hemorrhage (SAH). 4. History of cardiac diseases (such as coronary heart disease, heart failure, severe arrhythmias, congenital heart disease, cardiac surgery, valvular heart disease, or undiagnosed significant cardiac symptoms). 5. Concomitant systemic diseases such as renal failure (eGFR \< 30), autoimmune disorders, severe infections, etc. 6. History of dementia, depression, or other psychiatric disorders. 7. Poor compliance and inability to cooperate with follow-up.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| death | 1 month, 3 months and 1 year after stroke onset | — |
| left ventricular ejection fraction | within 1 week after stroke onset | measured by transthoracic echocardiography; a marker of ventricular dysfunction and heart failure |
| blood N-terminal pro-brain natriuretic peptide (NT-proBNP) level | within 1 week after stroke onset | a marker of ventricular dysfunction and heart failure |
| functional outcome | 3 months and 1 year after stroke onset. | measured by modified Rankin scale (mRS), a 7-level ordinal scale (scores 0-6) used to assess global disability after stroke. Higher scores indicate worse functional outcome. |
| blood high-sensitivity cardiac troponin level | within 48 hours and at 72 hours after stroke onset | a marker of acute myocardial injury |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| post-stroke depression | 3 months and 1 year after stroke onset. | measured by Hamilton depression rating scale (HAMD), a widely used clinician-administered tool for assessing the severity of depression. HAMD score range: 0-52. Higher scores indicate higher depression severity. |
| post-stroke anxiety | 3 months and 1 year after stroke onset. | measured by Hamilton anxiety rating scale (HAMA), a clinician-administered tool to assess the severity of anxiety symptoms. HAMA score range: 0-56. Higher scores indicate higher anxiety severity. |
| post-stroke cognitive impairment | 3 months and 1 year after stroke onset. | measured by Montreal Cognitive Assessement (MoCA), a widely used screening tool designed to detect mild cognitive impairment and dementia. MoCA score range: 0-30, higher scores indicate better cognitive function. |
Countries
China
Contacts
Primary ContactChensheng Pan, M.D.
Backup ContactZhou Zhu, MD, PhD
Outcome results
None listed