Young adults with cryptogenic ischemic stroke demonstrated altered left atrial dynamics, including smaller LA reservoir volumes (10.2 vs 13.2 mL; P=0.030), compared to stroke-free controls.
Case-Control (n=60)
Does advanced echocardiography reveal altered left atrial dynamics in young adults with cryptogenic ischemic stroke compared to stroke-free controls?
Young adults with cryptogenic ischemic stroke exhibit altered left atrial dynamics on advanced echocardiography, suggesting that left atrial wall pathology may contribute to the etiology of these strokes.
Absolute Event Rate: 10.2% vs 13.2%
p-value: p=0.030
Background Ischemic stroke in young individuals often remains cryptogenic. Some of these strokes likely originate from the heart, and atrial fibrosis might be one of the etiological mechanisms. In this pilot study, we investigated whether advanced echocardiography findings of the left atrium ( LA ) of young cryptogenic stroke patients differ from those of stroke‐free controls. Methods and Results We recruited 30 cryptogenic ischemic stroke patients aged 18 to 49 years and 30 age‐ and sex‐matched stroke‐free controls among participants of the SECRETO (Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome) study ( NCT 01934725). We measured basic left ventricular parameters and detailed measures of the LA , including 4‐dimensional volumetry, speckle tracking epsilon, strain rate, and LA appendix orifice variation. Data were compared as continuous parameters and by tertiles. Compared with controls, stroke patients had smaller LA reservoir volumes (10.2 interquartile range, 5.4 versus 13.2 5.4 mL ; P =0.030) and smaller positive epsilon values (17.8 8.5 versus 20.8 10.1; P =0.023). In the tertile analysis, stroke patients had significantly lower left atrial appendage orifice variation (3.88 0.75 versus 4.35 0.90 mm; P =0.043), lower LA cyclic volume change (9.2 2.8 versus 12.8 3.5 mL ; P =0.023), and lower LA contraction peak strain rate (−1.8 0.6 versus −2.3 0.6; P =0.021). We found no statistically significant differences in left ventricular measures. Conclusions This preliminary comparison suggests altered LA dynamics in young patients with cryptogenic ischemic stroke, and thus that LA wall pathology might contribute to these strokes. Our results await confirmation in a larger sample.
Pirinen et al. (Wed,) conducted a case-control in Cryptogenic ischemic stroke (n=60). Advanced echocardiography vs. Stroke-free controls was evaluated on Left atrial reservoir volume (p=0.030). Young adults with cryptogenic ischemic stroke demonstrated altered left atrial dynamics, including smaller LA reservoir volumes (10.2 vs 13.2 mL; P=0.030), compared to stroke-free controls.