To evaluate the association between left ventricular systolic dysfunction (LVSD) measured by left ventricular ejection fraction (LVEF) and 90 d clinical outcomes in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) in the anterior cerebral circulation who underwent endovascular thrombectomy (EVT) between 6-24 h.

The clinical data of AIS patients with LVO in the anterior cerebral circulation who underwent EVT between 6-24 h after symptom onset in our hospita from January 2018 to January 2021 were retrospectively analyzed. LVEF was measured on two-dimensional echocardiography using Simpson's biplane method of discs according to international guidelines. LVSD was defined as LVEF < 50%. A modified Rankin Scale (mRS) of 3-6 at 90 d was defined as a poor functional outcome. The univariate and multivariate logistic regression analyses were used to access the correlation between LVSD and 90 d poor clinical outcome.

A total of 107 patients were enrolled in this study, of whom 26 (24.3%) patients had LVSD. On multivariate analyses, LVSD (OR =4.206, 95%CI: 1.357-13.035, P = 0.013), baseline high National Institutes of Health Stroke Scale (NIHSS) score (OR = 1.234, 95%CI: 1.114-1.367, P < 0.001) and poor reperfusion (mTICI 0-2a) (OR = 4.388, 95%CI: 1.373-14.023, P=0.013) were independent predictors of 90 d poor functional outcomes. Age(OR = 1.081, 95%CI: 1.005-1.161, P = 0.035), LVSD (OR = 3.783, 95%CI: 1.029-13.911, P = 0.045), and baseline high National Institutes of Health Stroke Scale (NIHSS) score (OR = 1.109, 95%CI: 1.026-1.198, P = 0.009) were independent risk factors for 90 d mortality.

LVSD was independently associated with 90 d poorer outcomes in AIS patients with LVO in the anterior circulation who underwent EVT between 6-24 h.