Acute myocardial injury occurred in 21% of acute stroke patients and was significantly associated with lesions in the left insula and bilateral basal ganglia and widespread structural disconnection involving central autonomic network regions.
Observational (n=281)
No
Acute myocardial injury occurs in approximately one-fifth of acute stroke patients and is associated with specific brain lesions and structural disconnections in the central autonomic network, supporting the concept of stroke-induced autonomic dysregulation.
Absolute Event Rate: 21% vs 79%
Introduction Acute myocardial injury (AMI) is frequently observed in patients with acute stroke and may be linked to lesion location within the central autonomic network (CAN). However, neuroimaging findings remain inconsistent, and the neuroanatomical basis remains unclear. We investigated associations between lesion location, structural disconnection, and AMI in acute stroke. Methods In this single-center cohort, patients with ischemic or hemorrhagic stroke were screened for AMI using serial high-sensitivity cardiac troponin I (hs-cTnI) measurements within 48 h of admission. AMI was defined as hs-cTnI levels exceeding the 99th percentile of the reference limit with 20% dynamic change. Stroke lesions were segmented using Brainomix software and overlaid on a diffusion tensor imaging template to generate indirect structural disconnection maps. A voxel-based multivariate method (Sparse Canonical Correlation Analysis) identified associations between AMI and (a) directly damaged areas and (b) disconnected regions. Results Among 281 patients (mean age 71.4 ± 12.3 years), 59 (21%) developed AMI. AMI was associated with lesions in the left insula, basal ganglia, and adjacent white matter, as well as with widespread structural disconnection involving CAN regions. It was also significantly associated with older age, female sex, and higher NIHSS scores, but not with atrial fibrillation, diabetes, or hypertension. Conclusion In this cohort, AMI affected 21% of stroke patients and was significantly associated with specific lesion locations and widespread structural disconnection, including regions implicated in autonomic regulation, but not with traditional cardiovascular risk factors. These findings support the hypothesis that stroke-induced autonomic dysregulation may contribute to AMI development.
Mikulenka et al. (Wed,) conducted a observational in Adults admitted with acute ischemic or hemorrhagic stroke (n=281). None (observational cohort study) vs. Patients without acute myocardial injury was evaluated on Occurrence of acute myocardial injury defined by high-sensitivity cardiac troponin I exceeding 99th percentile with >20% dynamic change within 48 h of admission. Acute myocardial injury occurred in 21% of acute stroke patients and was significantly associated with lesions in the left insula and bilateral basal ganglia and widespread structural disconnection involving central autonomic network regions.