European Journal of Cardiovascular Medicine

Introduction: Cerebral cardiac syndrome (CCS) refers to cardiac dysfunction after brain injury.  Byer and colleagues   first   reported Cerebral cardiac syndrome in 1946. It is an interplay between brain and heart and is also known as neuro cardiogenic syndrome or stroke heart syndrome. CCS refers to cardiac complications that occur after stroke including arrhythmias, myocardial damage, and cardiac dysfunction. Ischemic stroke is   strongly   evidenced to induce CCS with prevalence of 4-19%. ECG changes   are reported in 65 -69% of ischemic stroke patients. Most of these ECG changes are seen early after stroke within the first 3 days. CCS is   worsening of premorbid cardiac conditions or new onset cardiac injury in stroke patients.   Materials and methods: This is a cross sectional study conducted in the Department of Neurology at Dr.Pinnamaneni Siddhartha Institute of Medical Sciences &Research Foundation, Chinnavutapalli, Vijayawada, Andhra Pradesh from July 2022 to June 2023 with a sample size of 51 patients. Patients of acute ischemic stroke within 72 hours with no previous cardiac disease. Data regarding age, sex, stroke territory, NIHSS score, 2d echo and ECG findings, blood investigations like prothrombin time and neutrophil count were analyzed. Results: A total of 51 ischemic stroke patients were included in this study; 49 patients with arterial infarcts and 2 with venous infarcts. Out of 51 ischemic stroke patients, 23 developed CCS accounting to an incidence of 45%. In 38 patients with   anterior circulation strokes, 39% (14) developed CCS. In 11 patients with posterior circulation strokes, 54% (6) patients developed CCS. ECG findings were recorded within 72 hours of acute stroke. Anterior circulation strokes: In strokes involving anterior circulation, 80% had ECG changes. T waves inversions accounted to 60% and T wave elevations to 20%, T wave inversion with co-existing ST elevation, ST depression and pathological Q waves were accounted for 6.6% each. Conclusion: Our study shows that ECG changes, NIHSS score, sex, prothrombin time, neutrophil count are independent risk factors for CCS correlating with the previous studies. However, our sample had more of posterior circulation strokes presenting with CCS rather than anterior circulation as reported by various studies. Dual role of neutrophils need to be further studied for targeted therapies to improve functional outcomes post stroke.