After a stroke, there is an increased risk of heart failure
It has long been known that people with heart failure develop strokes at an above-average rate. German researchers have now shown that the reverse course of the disease often occurs. After a stroke there is an increased risk of heart failure.
Relationship between stroke and heart failure
Every year, more than a quarter of a million people in Germany suffer a stroke. The stroke is one of the most common causes of death in Germany. In many cases, it also leads to permanent disabilities and secondary illnesses. One of these can also be heart failure, as German researchers have now discovered.
Influence on the treatment of stroke patients
It has long been known that people with heart failure (heart failure) suffer strokes more often than average.
Scientists at the Universities of Würzburg and Duisburg-Essen (UDE) have now been able to show for the first time that the reverse course of the disease often occurs: After a stroke, heart failure can develop for months.
They report about this and about therapeutic options in the specialist magazine "Annals of Neurology".
According to a UDE statement, the discovery of scientists and medical professionals has a potential impact on the treatment of stroke patients.
"In the case of a stroke, not only the brain function should be considered; long-term cardiac diagnostics must also be considered," said Prof. Christoph Kleinschnitz from the Department of Neurology at the Medical Faculty of the UDE at the University Hospital Essen.
Little is known about the long-term consequences
There has already been evidence that heart failure (HI) can develop as a result of a disorder in the autonomic nervous system. However, the exact mechanism behind it was unknown.
Previous studies in stroke patients only showed that up to several weeks after a stroke, cardiac arrhythmias, cardiac muscle cell death and functional disorders of the heart can occur.
Within the first three months after a stroke, 19 percent of all patients experience a serious cardiac incident: a heart attack or sudden cardiac death.
But little has been known about the long-term consequences of a stroke on the development of chronic heart failure.
Heart dysfunction after stroke
Thanks to the close collaboration of neurologists, cardiologists and clinical epidemiologists from the university clinics and the German Center for Heart Failure (DZHI), the “SICFAIL” project (deterioration of the heart caused by a stroke) has now been able to observe, evaluate and also evaluate the importance of stroke-induced heart failure develop new treatment strategies.
SICFAIL consists of an experimental and a clinical part that has not yet ended.
"The basic hypothesis is that an IS (Ischemic stroke, triggered by a sudden reduced blood flow to the brain) induces chronic heart failure (HI) and that this is fundamentally amenable to pharmacological intervention," said natural scientist Dr. Michael Bieber from the Würzburg University Hospital.
An important milestone for this was the proof that a functional dysfunction of the heart actually develops after an experimental stroke. The pump function was significantly reduced eight weeks after stroke induction.
This neurocardial damage is triggered by chronic overactivation in part of the nervous system, the sympathetic nervous system. This problem also leads to increased collagen formation directly on the heart.
The scientists tested a pharmacological strategy to prevent HI after stroke. The beta blocker metoprolol was administered, as is also done in HI patients.
This lowered the sympathetic activation, significantly improved the heart function and the morphological changes in the heart did not occur.
"If the experimental results in the clinical part of the SICFAIL study can be confirmed, this drug therapy with a beta blocker could also be a useful starting point for patients after a stroke," explained Prof. Stefan Frantz, cardiologist and director of the medical clinic and polyclinic I at the University Hospital Würzburg.
“The recruitment and basic examinations for the clinical part were successfully completed in the middle of the year. The annual follow-up surveys are still ongoing. The results of the first analyzes are expected early next year, ”added Prof. Peter Heuschmann, head of the Chair for Clinical Epidemiology and Biometry at the Julius Maximilians University (JMU) in Würzburg. (ad)