Left Atrium Assessment by Speckle Tracking Echocardiography in Cryptogenic Stroke : Seeking Silent Atrial Fibrillation
Ble, Mireia (Universitat Autònoma de Barcelona. Departament de Medicina)
Benito, Begoña (Institut Hospital del Mar d'Investigacions Mèdiques)
Cuadrado-Godia, Elisa (Hospital del Mar (Barcelona, Catalunya))
Pérez-Fernández, Silvia (Institut Hospital del Mar d'Investigacions Mèdiques)
Gómez, Miquel (Hospital de Barcelona)
Mas-Stachurska, Aleksandra (Institut Hospital del Mar d'Investigacions Mèdiques)
Tizón-Marcos, Helena (Institut Hospital del Mar d'Investigacions Mèdiques)
Molina, Lluis (Hospital de Barcelona)
Martí-Almor, Julio (Institut Hospital del Mar d'Investigacions Mèdiques)
Cladellas Capdevila, Mercè (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2021
Resum:	Silent atrial fibrillation (AF) may be the cause of some cryptogenic strokes (CrS). The aim of the study was to analyse atrial size and function by speckle tracking echocardiography in CrS patients to detect atrial disease. Patients admitted to the hospital due to CrS were included prospectively. Echocardiogram analysis included left atrial ejection fraction (LAEF) and atrial strain. Insertable cardiac monitor was implanted, and AF was defined as an episode of ≥1 min in the first year after stroke. Left atrial enlargement was defined as indexed volume > 34 mL/m 2. Seventy-five consecutive patients were included, aged 76 ± 9 years (arterial hypertension 75%). AF was diagnosed in 49% of cases. The AF group had higher atrial volume and worse atrial function: peak atrial longitudinal strain (PALs) 19. 6 ± 5. 7% vs. 29. 5 ± 7. 2%, peak atrial contraction strain (PACs) 8. 9 ± 3. 9% vs. 16. 5 ± 6%, LAEF 46. 8 ± 11. 5% vs. 60. 6 ± 5. 2%; p < 0. 001. AF was diagnosed in 20 of 53 patients with non-enlarged atrium, and in 18 of them, atrial dysfunction was present. The multivariate logistic regression analysis demonstrated an independent association between detection of AF and atrial volume, LAEF, and strain. Cut-off values were obtained: LAEF < 55%, PALs < 21. 4%, and PACs < 12. 9%. In conclusion, speckle tracking echocardiography in CrS patients improves silent atrial disease diagnosis, with or without atrial enlargement.
Ajuts:	Ministerio de Economía y Competitividad PI13/01830
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Atrial fibrillation ; Echocardiography ; Atrial strain ; Atrial disease ; Cryptogenic stroke
Publicat a:	Journal of clinical medicine, Vol. 10 (august 2021) , ISSN 2077-0383

DOI: 10.3390/jcm10163501
PMID: 34441797

10 p, 1.5 MB

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