Key result
LAFI ≤0.3 is linked to ~430% greater cardioembolic stroke risk.
Why the study?
Ischaemic stroke frequently has a cardioembolic source, motivating an evaluation of clinical and echocardiographic parameters associated with cardioembolic stroke.
Are left atrial volume and function parameters associated with a cardioembolic etiology in patients with ischaemic stroke?
Observational (n=166)
Are left atrial volume and function parameters associated with a cardioembolic etiology in patients with ischaemic stroke?
Odds Ratio: 5.3
p-value: p=0.001
Reduced left atrial function, particularly a left atrial function index ≤0.3, is a strong independent predictor of cardioembolic stroke and suggests an underlying atrial myopathy in strokes of undetermined etiology.
LAFI ≤0.3 was associated with cardioembolic stroke; hypothesis-generating for atrial myopathy in undetermined etiology, pending prospective validation.
Background and purpose Ischaemic stroke frequently has a cardioembolic ( CE ) source. Clinical and echocardiographic parameters associated with CE stroke were evaluated. Methods In all, 93 consecutive ischaemic stroke patients who underwent a transthoracic echocardiogram were retrospectively analysed; strokes were classified by TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. Echocardiographic parameters related to CE stroke, including left atrial volumes and function, were compared to 73 healthy controls. Results Of 93 patients (mean age 66.1 years, 56% male), nine (10%) had large artery atherosclerosis, 38 (41%) CE stroke, two (2%) small vessel disease, two (2%) other and 42 (45%) undetermined aetiology. Left atrial ( LA ) maximum volumes ( LAVI max ) and minimum volumes ( LAVI min ) were larger in the CE group than the non‐ CE group (45 vs. 32 ml/m 2 , 32 vs. 13 ml/m 2 , respectively, P < 0.001), whilst LA function indices including LA emptying fraction and LA function index ( LAFI ) were lower in the CE group (34% vs. 55%, and 0.12 vs. 0.35, respectively, P < 0.001). Adjusting for clinical characteristics, LAFI ≤0.3 was an independent predictor of CE stroke (adjusted odds ratio 5.3, P = 0.001). Additionally, LAVI max and LAVI min were larger (61 vs. 44 and 32 vs. 24 ml/m 2 respectively, P < 0.01) and LAFI significantly lower (0.34 vs. 0.52, P < 0.001) in the undetermined aetiology group versus healthy controls. Conclusions Left atrial enlargement with reduced LA function was associated with CE stroke and LAFI was the best independent predictor. LA parameters were also altered in the undetermined aetiology group, suggesting an underlying LA myopathy in this subset.
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Ferkh et al. (2019) conducted an observational in Ischaemic stroke (n=166). Left atrial function index (LAFI) ≤0.3 vs. LAFI >0.3 was evaluated on Cardioembolic stroke (adjusted OR 5.3, p=0.001). A left atrial function index (LAFI) ≤0.3 was an independent predictor of cardioembolic stroke (adjusted OR 5.3, P=0.001).
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