Left ventricular dysfunction in acute ischaemic stroke

Background: Patient education is a vital component of Heart Failure Management Programs (HF-MPs) and should be specifically designed to meet the needs of this patient population. Aim: To investigate the learning style and preferences for information delivery of heart failure patients for the purposesof informing thedesignofeducational resources. Methods: A purposive sample of 12 participants, diagnosed with heart failure and enrolled in a HF-MP, participated in semi-structured in-depth interviews. Results: Four themes emerged: knowledge quest (L(AIS) causes alteration to left ventricular volumes and function. We studied patients with acute ischaemic stroke using NT–pro-BNP blood assays on days 1 and 5 after admission to Gosford Hospital Stroke Unit. Patients were submitted to 3-dimentional (3-D) echocardiographic assessment using Phillips Sonos 7500 Equipment. End diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) were measured on presentation and days 3–5 following admission. The echocardiographic images were analysed using Phillips Q Lab Software. NT–pro-BNP level at presentation (mean±S.E.) was 1027± 429 pg/ml (N= 14) which was higher than day 5 (535± 215 pg/ml, N= 14, p< 0.5). Day 1 EDV, ESV and SV were 87± 6 ml, 44± 5ml and 48± 3ml, respectively (N= 21). Day 1 EFwas 55± 3 (N= 21). Days 3–5 EDV, ESV and SV were 90± 7ml, 43± 6ml and 53± 4ml, respectively (N= 21). Days 3–5 EF was 58± 4 (N= 21). The results demonstrate a trend towards a reduction in EF and SV in the acute post-AIS phase associated with evidence of neurohormonal regulation. The role of BNP in altering myocardial kinetics in early post-AIS phase deserves further investigation and needs to be viewed in the context of interaction between different neurohormones including catecholamines.