Key result
New AF after cryptogenic stroke is linked to ~8 mL/m2 higher LAVI and lower atrial strain.
Why the study?
AF is an important cause of cryptogenic stroke, and left atrial indices have been investigated as markers of asymptomatic AF among cryptogenic stroke survivors.
Are left atrial echocardiographic indices (LAVI, LASr, LASct) associated with newly detected atrial fibrillation in patients with cryptogenic stroke?
Meta-Analysis (n=3,475)
Are left atrial echocardiographic indices (LAVI, LASr, LASct) associated with newly detected atrial fibrillation in patients with cryptogenic stroke?
Effect estimate: MD 7.76 mL/m2 (95% CI 6.04 to 9.49)
p-value: p=< 0.00001
Left atrial enlargement and reduced strain are significantly associated with the detection of new-onset atrial fibrillation in patients with cryptogenic stroke, suggesting these echocardiographic indices could help stratify risk for AF monitoring.
Supports LA indices for AF risk stratification post-cryptogenic stroke; leaves open prospective validation before guiding monitoring.
Introduction Atrial fibrillation (AF) is linked with cardioembolism and serves as an important underlying etiology of cryptogenic stroke (CS). Left atrial (LA) indices have been investigated as markers of asymptomatic AF among CS survivors. We aimed to evaluate the association between LA indices and newly detected AF following CS. Methods A literature search through PubMed, Scopus, Cochrane Library, and Europe PMC identified observational studies enrolling CS patients without prior AF who were monitored for AF. Left atrial volume index (LAVI), left atrial reservoir strain (LASr), and left atrial contractile strain (LASct) were assessed using echocardiography at admission and compared between patients with or without new‐onset AF. Subgroup analysis was conducted for patients with embolic stroke of undetermined source (ESUS). Pooled mean differences with 95% confidence intervals (CIs) were measured using the random‐effects model. Results Twenty‐three studies comprising 3475 participants (AF = 1050; non‐AF = 2425) were included in the analysis, with 11 studies assessing exclusively ESUS patients. Meta‐analysis demonstrated significantly higher LAVI (MD 7.76 mL/m 2 ; 95% CI 6.04 to 9.49; I 2 = 72%; p < 0.00001) and significantly lower LASr (MD −8.07%; 95% CI −10.13 to −6.01; I 2 = 88%; p<0.00001) and LASct (MD −5.26%; 95% CI −6.69 to −3.83; I 2 = 86%; p < 0.00001) in CS patients who developed AF compared with those who did not. Similarly, significantly higher LAVI and lower LASr and LASct were observed in ESUS patients with new‐onset AF. Conclusion In conclusion, AF occurrence is associated with higher LAVI and lower LASr and LASct among CS patients, suggesting an association between LA function and newly detected AF.
No takes yet. Share an insight, caveat, or question.
Bramantyo et al. (2026) conducted a meta-analysis in Cryptogenic stroke (n=3,475). Left atrial echocardiographic indices (LAVI, LASr, LASct) vs. Patients without new-onset atrial fibrillation was evaluated on Left atrial volume index (LAVI) difference between patients with and without new-onset atrial fibrillation (MD 7.76 mL/m2, 95% CI 6.04 to 9.49, p=< 0.00001). Among cryptogenic stroke patients, newly detected AF was associated with significantly higher left atrial volume index (MD 7.76 mL/m2; 95% CI 6.04-9.49) and lower reservoir and contractile strain.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: