"The link between the brain and the heart in stroke patients is fascinating. For instance, most patients with acute stroke have elevated blood pressure that returns to baseline over three to seven days. The connection is believed to be through the autonomic nervous system, but what the mechanism is has been unclear," says A. Gregory Sorensen, MD, of the Martinos Center, the paper's senior author. "By finding a specific brain area associated with a dramatically increased risk of heart damage, we can identify at-risk patients when they arrive at the hospital and put them on protective therapy, which should have a direct impact on their care."
The current study led by first author Hakan Ay, MD, analysed data from 50 patients with ischemic strokes who also had myocardial damage as measured by elevated levels of troponins. Information from 50 other stroke patients, randomly selected from those who did not have increased troponins, was used for control comparison.
MR imaging data from all the patients was combined to create brain maps highlighting areas where brain tissue was more likely to be injured in patients with elevated troponins than in those with no evidence of cardiac damage. The results showed that patients whose stroke affected the right insular area had a 15 times greater risk for subsequent heart muscle injury than did patients with damage in other areas.
"This image analysis technique is a more sophisticated way of understanding how the brain is organized and what are the effects of damage to specific structures," says Sorensen. "Future studies may help us determine which stroke patients are more likely to have complications like pneumonia or disruptions in heart rhythm."
MEDICA.de; Source: Massachusetts General Hospital