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Outcomes of heart transplant recipients with prior left ventricular assist device associated stroke
Left ventricular assist devices (LVADs) improve survival in patients with end-stage heart failure but are associated with ischemic stroke and intracranial hemorrhage (ICH). The impact of LVAD-associated stroke on transplant candidacy and outcomes has not been characterized.
Source: Journal of Stroke and Cerebrovascular Diseases - June 7, 2023 Category: Neurology Authors: Aaron Shoskes, Merry Huang, Catherine Hassett, Randall C Starling, Eileen Hsich, Edward Soltesz, Sung-Min Cho, Ken Uchino Source Type: research

Radiographic risk factors for intracranial hemorrhage in patients with left ventricular assist devices
Patients with end-stage cardiomyopathy may require the use of mechanical circulatory support to maintain perfusion of the vital organs. This is most commonly achieved using an implantable left ventricular assist device (LVAD), typically used as a bridge to orthotopic heart transplant (BTT) or as destination therapy (DT) for those who are not transplant candidates. An LVAD is usually considered for those patients whose disease and symptoms meet INTERMACS Levels 2-4 criteria, indicating a significant decrease in functionality.
Source: Journal of Stroke and Cerebrovascular Diseases - November 1, 2022 Category: Neurology Authors: Nicholas S. Hernandez, Matthew Kanter, Vaishnavi Sharma, Andy Wang, Michael Kiernan, Delia Kryzanski, Robert Heller, Tara Nail, Ron I. Riesenburger, James T. Kryzanski Source Type: research

Stroke in Patients with Left Ventricular Assist Devices
Background: Left ventricular assist devices (LVADs) are artificial pumps used in end-stage heart failure to support the circulatory system. These cardiac assist devices work in parallel to the heart, diverting blood from the left ventricle through an outflow graft and into the ascending aorta. LVADs have allowed patients with end-stage heart failure to live longer and with improved quality of life compared to best medical therapy alone. However, they are associated with significant risks related to both thrombosis and bleeding in this medically complex patient population. As LVADs continue to be used more widely, stroke ne...
Source: Cerebrovascular Diseases - September 10, 2021 Category: Neurology Source Type: research

The Joint Association of Septicemia and Cerebrovascular Diseases with In-Hospital MortalityAmong Patients with Left Ventricular Assist Device in the United States
Currently, about 6.2 million adults in the US are reported to have heart failure, and this prevalence is expected to increase by 46% by 2030.1 The prognosis of advanced heart failure especially, advanced systolic heart failure, has improved tremendously with the advent of implantable mechanical circulatory support devices such as left ventricular assist device (LVAD) which is often used as a bridge to heart transplantation or as a destination therapy.2,3 Indeed, LVAD has improved the 1-year survival of patients with advanced heart disease from 52% to about 85%.
Source: Journal of Stroke and Cerebrovascular Diseases - January 19, 2021 Category: Neurology Authors: Jessica Lovelace, Obadeh Shabaneh, Noah De La Cruz, Damilola R. Owoade, Chike C. Nwabuo, Nandini Nair, Duke Appiah Source Type: research

Management of Intracranial Hemorrhage in Patients with a Left Ventricular Assist Device: A Systematic Review and Meta-Analysis
Left Ventricular Assist Device (LVAD) therapy serves as a surgically implanted form of mechanical circulation in patients with advanced heart failure. Initially designed to provide a bridge to transplant, LVADs now offer an alternative that is increasingly utilized as final destination therapy as the need for donor hearts increases worldwide.1,2 However, this requires lifelong anticoagulation (AC) to prevent pump thrombosis, resulting in hemorrhagic risks.3
Source: Journal of Stroke and Cerebrovascular Diseases - December 1, 2020 Category: Neurology Authors: Austin H. Carroll, Michael P. Ramirez, Ehsan Dowlati, Kyle B. Mueller, Ali Borazjani, Jason J. Chang, Daniel R. Felbaum Tags: Review Article Source Type: research

Using Dental Pulp Stem Cells for Stroke Therapy
Conclusion and Future Perspectives Stem cell-based therapy is a promising alternative for stroke treatment. While stem cells from different sources, including induced PSC, ESC, MSC, and NSC, have been investigated, using NSC and enhancing the natural mechanisms is most appropriate for brain repair. In preclinical models of stroke, stem cell transplantation has led to positive outcomes through a variety of cellular and molecular mechanisms, many being mediated by the array of beneficial factors produced by the cells. Recent advances in cellular reprogramming have provided alternative sources of NSC to be investigated, allo...
Source: Frontiers in Neurology - April 28, 2019 Category: Neurology Source Type: research

Neurological Involvement in Primary Systemic Vasculitis
Conclusion Neurological involvement is a common complication of PSV (Table 1), and neurologists play an important role in the identification and diagnosis of PSV patients with otherwise unexplained neurological symptoms as their chief complaint. This article summarizes the neurological manifestations of PSV and hopes to improve neuroscientists' understanding of this broad range of diseases. TABLE 1 Table 1. Common CNS and PNS involvements of primary systemic vasculitis. Author Contributions SZ conceived the article and wrote the manuscript. DY and GT reviewed and edited the manuscript. All authors ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Stroke Dysbiosis Index (SDI) in Gut Microbiome Are Associated With Brain Injury and Prognosis of Stroke
Conclusions: We developed an index to measure gut microbiota dysbiosis in stroke patients; this index was significantly correlated with patients' outcome and was causally related to outcome in a mouse model of stroke. Our model facilitates the potential clinical application of gut microbiota data in stroke and adds quantitative evidence linking the gut microbiota to stroke. Introduction Ischemic stroke imposes a heavy burden on society, with 24.9 million cases worldwide (1). Although intravenous thrombolysis and endovascular treatment greatly improve some patients' prognosis, the prognosis for most pa...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

World-Wide Efficacy of Bone Marrow Derived Mesenchymal Stromal Cells in Preclinical Ischemic Stroke Models: Systematic Review and Meta-Analysis
Conclusions: Our results show worldwide efficacy of BM-MSCs in improving functional outcomes in pre-clinical animal models of stroke and support testing these cells in clinical trials in various ranges of time windows using different delivery routes. The continued growing number of publications showing functional benefit of BM-MSCs are now adding limited value to an oversaturated literature spanning 18 years. Researchers should focus on identifying definitive mechanisms on how BM-MSCs lead to benefit in stroke models. Introduction Ischemic stroke is the 5th leading cause of death and the leading cause of long term di...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Cryptotanshinone Attenuates Oxygen-Glucose Deprivation/ Recovery-Induced Injury in an in vitro Model of Neurovascular Unit
Conclusions Despite the above limitations, we indicate that the protective mechanism of CTs against OGD/R damage might exert via inhibiting neuron apoptosis and attenuating BBB disruption. Furthermore, we also clarified that CTs inhibited neuronal apoptosis possibly by blocking the activation of MAPK signaling pathways, and CTs alleviating BBB disruption may associated with the regulation of TJPs and MMP-9 in our experiment. Accordingly, CTs will represent a novel and potent candidate for the treatment of CIRI in the future. Ethics Statement This study was carried out in accordance with the recommendations of China�...
Source: Frontiers in Neurology - April 17, 2019 Category: Neurology Source Type: research

Conveniently-Grasped Field Assessment Stroke Triage (CG-FAST): A Modified Scale to Detect Large Vessel Occlusion Stroke
Conclusions: CG-FAST scale could be an effective and simple scale for accurate identification of LVOS among AIS patients. Introduction Large vessel occlusion stroke (LVOS) often leads to severe disability and mortality. Although endovascular therapy (EVT) has been proved to be effective for LVOS patients (1–9), especially in anterior circulation, its benefit is highly time-dependent (10, 11). As hospitals with around-the-clock endovascular capability are scarce in many parts of the world and patients admitted directly to a CSC would have better outcomes than those receiving drip and ship treatment (12, 13), t...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Cell-Based Therapies for Stroke: Promising Solution or Dead End? Mesenchymal Stem Cells and Comorbidities in Preclinical Stroke Research
Conclusion The high prevalence of comorbidities in patients with stroke indicates the need for therapies in preclinical studies that take into account these comorbidities in order to avoid failures in translation to the patient. Preclinical studies are beginning to evaluate the efficacy of MSC treatment in stroke associated with comorbidities, especially hypertension, for ischemic and hemorrhagic stroke. Regarding aging and diabetes, only ischemic stroke studies have been performed. For the moment, few studies have been performed and contradictory results are being reported. These contradictory results may be due to the u...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Cerebrovascular Accidents During Mechanical Circulatory Support Clinical Sciences
Conclusions—Stroke is a major cause of morbidity and mortality in patients on LVAD support. Chronic obstructive pulmonary disease increases the risk of ischemic stroke, whereas dialysis may increase the risk of hemorrhagic stroke. Although any stroke increases mortality, post-LVAD hemorrhagic stroke was associated with higher mortality compared with ischemic stroke.
Source: Stroke - April 23, 2018 Category: Neurology Authors: Saef Izzy, Daniel B. Rubin, Firas S. Ahmed, Feras Akbik, Simone Renault, Katelyn W. Sylvester, Henrikas Vaitkevicius, Jennifer A. Smallwood, Michael M. Givertz, Steven K. Feske Tags: Heart Failure, Complications, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Cerebrovascular Events After Continuous-Flow Left Ventricular Assist Devices
ConclusionsLVADs are associated with high rates of CVE, increased mortality, and lower rates of heart transplantation. Further investigations to identify the optimal primary and secondary stroke prevention measures in post-LVAD patients are warranted.
Source: Neurocritical Care - April 10, 2018 Category: Neurology Source Type: research

Ischemic Stroke in a Young Patient Heralding a Left Ventricular Noncompaction Cardiomyopathy
We report the case of a young woman whose ischemic stroke led to the diagnosis of a rare embolic cardiomyopathy, left ventricular noncompaction cardiomyopathy, requiring a heart transplant.Case Rep Neurol 2017;9:204 –209
Source: Case Reports in Neurology - October 25, 2017 Category: Neurology Source Type: research

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