Arrhythmias & electrophysiology
Left atrial sphericity and strain augment risk prediction in patients with embolic stroke of undetermined source
Authors' conclusion
LA reservoir and conduit strain, and circularity have independent and incremental association with the occurrence of recurrent-stroke and new-AF in ESUS patients. This may represent measurable non-invasive markers of atrial cardiomyopathy in a subset of ESUS patients and enable risk-stratification and targeted intervention. Future longitudinal studies are needed to confirm these findings.
Study context
- Population
- Ischaemic stroke patients: Embolic Stroke of Undetermined Source (ESUS) and non-cardioembolic stroke (non-CES)ESUS 203 · non-CES 256
- Participants
- 203 vs 256
- Exposure
- Left atrial (LA) parameters in ESUS patients compared to non-CES patients; LA parameters associated with recurrent-stroke and new-AF in ESUS patients
- ESUSn = 203
- non-CESn = 256
- Outcome
- LA volume, reservoir and contractile strain, circularity
Main finding
As reported in the abstract
ESUS patients had increased LA volume, reduced reservoir and contractile strain, and increased circularity compared to non-CES patients
P < 0.002 for all
Observational data: associations, not effects.
Further findings
- Recurrent-stroke; recurrent-stroke or new-AF (ESUS patients)
- 36(18%) · recurrent-stroke · recurrent-stroke or new-AF 54(27%)
Association of LA parameters with recurrent-stroke and recurrent-stroke or new-AF (ESUS patients)
- Larger LA volume, reduced phasic LA strain (reservoir, contractile and conduit), and increased circularity were associated with both outcomes
- P < 0.05 for all
- Independent and incremental value for reservoir and conduit strain, and circularity, in identifying patients at risk of recurrent-stroke and new-AF
Original publication
Summarised from the published abstract; every number is checked against it