Echocardiographic Abnormalities and Determinants of 1-Month Outcome of Stroke Among West Africans in the SIREN Study

Abiodun M. Adeoye, Bruce Ovbiagele, Joshua O. Akinyemi, Okechukwu S. Ogah, Rufus Akinyemi, Mulugeta Gebregziabher, Kolawole Wahab, Adekunle G. Fakunle, Adeseye Akintunde, Oladimeji Adebayo, Akinyemi Aje, Hemant K. Tiwari, Donna Arnett, Francis Agyekum, Lambert T. Appiah, Ganiyu Amusa, Taiwo O. Olunuga, Akpa Onoja, Fred S. Sarfo, Albert AkpaluCarolyn Jenkins, Daniel Lackland, Lukman Owolabi, Morenikeji Komolafe, Moyinoluwalogo M. Faniyan, Oyedunni Arulogun, Reginald Obiako, Mayowa Owolabi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Little is known about the relationship between echocardiographic abnormalities and outcome among patients with acute stroke. We investigated the pattern and association of baseline echocardiographic variables with 1-month disability and mortality among patients with stroke in the SIREN (Stroke Investigative Research and Education Network) study. Methods and Results: We enrolled and followed up consecutive 1020 adult patients with acute stroke with baseline transthoracic echocardiography from west Africa. To explore the relationship between echocardiographic variables and 1-month disability (using modified Rankin scale >3) and fatality, regression models were fitted. Relative risks were computed with 95% CIs. The participants comprised 60% men with a mean age of 59.2±14.6 years. Ischemic stroke was associated with smaller aortic root diameter (30.2 versus 32.5, P=0.018) and septal (16.8 versus 19.1, P<0.001) and posterior wall thickness at systole (18.9 versus 21.5, P=0.004). Over 90% of patients with stroke had abnormal left ventricular (LV) geometry with eccentric hypertrophy predominating (56.1%). Of 13 candidate variables investigated, only baseline abnormal LV geometry (concentric hypertrophy) was weakly associated with 1-month disability (unadjusted relative risk, 1.80; 95% CI, 0.97–5.73). Severe LV systolic dysfunction was significantly associated with increased 1-month mortality (unadjusted relative risk, 3.05; 95% CI, 1.36–6.83). Conclusions: Nine of 10 patients with acute stroke had abnormal LV geometry and a third had systolic dysfunction. Severe LV systolic dysfunction was significantly associated with 1 month mortality. Larger studies are required to establish the independent effect and unravel predictive accuracy of this association.

Original languageEnglish
Article numbere010814
JournalJournal of the American Heart Association
Issue number11
StatePublished - Jun 4 2019

Bibliographical note

Funding Information:
This work is supported by the National Institutes of Health and National Institute of Neurological Disorders and Stroke (grant U54HG007479).

Publisher Copyright:
© 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.


  • echocardiography
  • left ventricular geometry
  • morbidity/mortality
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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