[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-113574-en":3,"doc-seo-113574-105":31,"detail-sidebar-cat-0-en-105":93},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":28,"seo_description":14,"update_tm":29,"read_time":30},113574,1099513958607,"Jiven","https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399",7,"Healthcare","Stroke–heart syndrome: clinical presentation and underlying mechanisms","Cardiac complications frequently develop in the first days after an ischaemic stroke, ranging from myocardial injury and cardiac dysfunction to arrhythmias, with clinical overlap among these domains. Clinical and neuroimaging evidence, supported by animal research, indicates shared underlying mechanisms rather than isolated processes. Stroke-induced alterations in the central autonomic network disrupt neural control of the heart, promoting necrosis, microvascular dysfunction, demand ischaemia, and arrhythmogenesis—collectively termed stroke–heart syndrome. Cohort studies link this syndrome to poor short-term outcomes, while long-term consequences and specific therapeutic targets remain insufficiently defined.","Review  \nStroke–heart syndrome: clinical presentation and underlying mechanisms  \nJan FScheitz, Christian H Nolte, Wolfram Doehner, Vladimir Hachinski, Matthias Endres  \nCardiac complications are a frequent medical problem during the first few days after an ischaemic stroke, and patients present with a broad range of symptoms including myocardial injury, cardiac dysfunction, and arrhythmia, with varying overlap between these three conditions. Evidence from clinical and neuroimaging studies and animal research suggests that these cardiac disturbances share the same underlying mechanisms. Although the exact cascade of events has yet to be elucidated, stroke-induced functional and structural alterations in the central autonomic network, with subsequent dysregulation of normal neural cardiac control, are the assumed pathophysiology. This dysregulation can promote myocardial necrosis, microvascular dysfunction, coronary demand ischaemia, and arrhythmogenesis. These stroke-associated cardiac alterations can be summarised as a distinct so-called stroke–heart syndrome. Independent cohort studies have shown a strong association between this syndrome and unfavourable short-term prognosis; however, long-term consequences, including secondary cardiac events and death, are less well described and specific therapeutic targets are scarce. An integrated view of stroke–heart syndrome will offer opportunities to expedite research and inform clinical decision making.  \nIntroduction  \nCardiac complications represent a major medical challenge during acute stroke care.1–3 Severe adverse cardiac events including acute coronary syndrome, heart failure, and cardiac arrhythmia are reported in approximately 20% of patients with ischaemic stroke in randomised controlled trials, occurring predominantly within the first 3 days after the event.3 In addition, abroad range of oligosymptomatic, early (first few days to weeks) cardiac complications can be observed with contemporary diagnostic measures.4–8 Patients with ischaemic stroke are particularly prone to cardiac injury, because of the advanced age at which strokes generally occur, prevalence of cardiac comorbidities, and vascular risk factors. Importantly, cardiac complications after ischaemic stroke are associated with a poor functional prognosis and are the second leading cause of death in the first few weeks after the event.1–4  \nThe clinical observation that ischaemic stroke is often accompanied by electrocardiogram (ECG) alterations or by an increase of unspecific cardiac blood biomarkers was first described in the 1950s and 1960s.9,10 In the past 10 years, animal studies, clinical cohort studies, and neuro imaging studies have provided increasing evidence that the varying cardiac disturbances appearing after stroke probably share the same underlying mechanisms.11–15 Although stroke induced alterations of physiological autonomic cardiac control seem to have a crucial role, the underlying pathological mechanisms are unclear and therapeutic targets are unknown. This insufficient evidence might be due to the fact that each cardiac complication has been individually studied in some detail, but not as a distinct and whole clinical entity.  \nIn this Review, we outline the most recent evidence suggesting that these cardiac events can be summarised asa distinct so called stroke–heart syndrome. Moreover, we aim to provide an overview of the clinical manifestations of stroke–heart syndrome, summarise presumed underlying  \nmechanisms, and derive implications of the concept for research and practice. We will focus on ischaemic stroke, although similar occurrences of neurocardiogenic injury can be observed in other acute brain disorders, including subarachnoid haemorrhage, haemorrhagic stroke, traumatic brain injury, and seizures.16 The population of patients with ischaemic stroke, however, differs markedly from that of patients with other acute brain disorders, regarding age and cardiovascular comorbidities; fu","cbCainYg5DrHkBCP","https://ap.wps.com/l/cbCainYg5DrHkBCP","pdf",691969,9,1,12,"English","en",105,"# Introduction\n## Cardiac complications associated with stroke\n## Stroke–heart syndrome concept and clinical timing\n## Distinguishing causes of cardiac disturbances","[{\"question\":\"What symptoms and findings are included in stroke–heart syndrome?\",\"answer\":\"Stroke–heart syndrome encompasses myocardial injury, cardiac dysfunction, and arrhythmias, often occurring with electrocardiogram changes and/or elevated cardiac biomarkers after ischaemic stroke.\"},{\"question\":\"What mechanism is proposed to underlie stroke–heart syndrome?\",\"answer\":\"It is driven by stroke-induced functional and structural changes in the central autonomic network, leading to dysregulation of neural cardiac control and subsequent myocardial and microvascular injury.\"},{\"question\":\"How does stroke–heart syndrome prognosis compare between short-term and long-term outcomes?\",\"answer\":\"Independent cohort studies show a strong association with unfavourable short-term prognosis, while long-term consequences such as secondary cardiac events and death are less well described.\"}]","Stroke–heart syndrome: clinical presentation and underlying mechanisms | 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symptoms and findings are included in stroke–heart syndrome?","Question",{"text":77,"@type":78},"Stroke–heart syndrome encompasses myocardial injury, cardiac dysfunction, and arrhythmias, often occurring with electrocardiogram changes and/or elevated cardiac biomarkers after ischaemic stroke.","Answer",{"name":80,"@type":75,"acceptedAnswer":81},"What mechanism is proposed to underlie stroke–heart syndrome?",{"text":82,"@type":78},"It is driven by stroke-induced functional and structural changes in the central autonomic network, leading to dysregulation of neural cardiac control and subsequent myocardial and microvascular injury.",{"name":84,"@type":75,"acceptedAnswer":85},"How does stroke–heart syndrome prognosis compare between short-term and long-term outcomes?",{"text":86,"@type":78},"Independent cohort studies show a strong association with unfavourable short-term prognosis, while long-term consequences such as secondary cardiac events and death are less well 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