Key result
Young adults with ESUS exhibit ~25% lower LAA ostium variation versus matched controls.
Why the study?
Atrial cardiopathy is a potential thrombogenic substrate for ESUS without atrial fibrillation, and LA myocardial deformation analysis may serve as a subclinical marker.
Does left atrial mechanical dysfunction or atrial cardiopathy associate with embolic stroke of undetermined source in young adults?
Case-Control (n=62)
Blinded outcome assessment
No
Does left atrial mechanical dysfunction or atrial cardiopathy associate with embolic stroke of undetermined source in young adults?
In young adults with embolic stroke of undetermined source, left atrial mechanical function and atrial cardiopathy prevalence were similar to healthy controls, though left atrial appendage ostium variation was significantly lower.
LA strain and AC markers did not differ in young ESUS patients versus controls; leaves open LAA role and requires larger prospective validation before clinical use.
BACKGROUND: Atrial cardiopathy (AC) has emerged as a potential pathological thrombogenic atrial substract of embolic stroke of undetermined source (ESUS), even in the absence of atrial fibrillation. Left atrium (LA) myocardial deformation analysis may be of value as a subclinical marker of AC and a predictor of ESUS. AIMS: To compare LA mechanical function between ESUS cases and age and sex-matched controls. METHODS: A single-center analytical study with case-control design was performed. Case group was composed by young patients admitted in the Neurology department from January 2017 to June 2021. Control group was composed by age and sex matched controls recruited from the community. All participants performed echocardiogram and a smaller sample underwent cardiac magnetic resonance. RESULTS: We recruited 31 ESUS patients aged between 18 and 65 years and 31 age and sex matched controls. ESUS patients had a significantly higher prevalence of cardiovascular risk factors and patent foramen ovale (PFO). The prevalence of AC was not different between groups. Echocardiogram parameters, including strain analysis, were similar between groups, except for LA appendage (LAA) ostium variation which was significantly lower in ESUS patients (absolute: 6.5vs8.7mm, p<0.001; relative: 44.5%vs53.4%, p=0.002). After exclusion of patients with PFO, all the results were statistically similar. Regarding cardiac magnetic resonance analysis, there were no statistically significant differences between groups. CONCLUSION: This study shows that in our population atria cardiopathy and atrial function was not associated with ESUS.LAA structural and functional abnormalities may play a major role. The role of LAA in ESUS warrants further studies.
No takes yet. Share an insight, caveat, or question.
Silva et al. (2022) conducted a case-control in Embolic stroke of undetermined source (ESUS) (n=62). Embolic stroke of undetermined source (ESUS) vs. Age and sex-matched healthy controls was evaluated on Left atrial appendage (LAA) ostium absolute variation (p=<0.001). Young adults with embolic stroke of undetermined source had significantly lower left atrial appendage ostium absolute variation compared to matched controls (6.5 vs 8.7 mm, p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: