BACKGROUND AND PURPOSE: We assessed whether echocardiography can predict paroxysmal atrial fibrillation (PAF) in patients with cerebral ischemia presenting in sinus rhythm. METHODS: Within the prospective Find-AF cohort, 193 consecutive patients with cerebral ischemia and sinus rhythm on presentation had evaluation of echocardiographic parameters of left atrial size and function. PAF was diagnosed by 7-day Holter monitoring. RESULTS: In 26 patients with PAF, late diastolic Doppler (A) and tissue Doppler (a') velocities were lower whereas left atrial diameter, left atrial volume index (LAVI), LAVI/A, and LAVI/a' were larger (P<0.05 for all) than they were in 167 patients without PAF. In multivariate models A, a', LAVI/A, and LAVI/a' predicted the presence of PAF. Area under the receiver operating characteristic curve to diagnose PAF was highest for LAVI/a' (0.813 [0.738; 0.889]). A previously suggested cut-off of LAVI/a'<2.3 had 92% sensitivity, 55.8% specificity, and 98% negative predictive value for PAF. CONCLUSIONS: LAVI/a'<2.3 can effectively rule out PAF in patients with cerebral ischemia.
BACKGROUND AND PURPOSE: We assessed whether echocardiography can predict paroxysmal atrial fibrillation (PAF) in patients with cerebral ischemia presenting in sinus rhythm. METHODS: Within the prospective Find-AF cohort, 193 consecutive patients with cerebral ischemia and sinus rhythm on presentation had evaluation of echocardiographic parameters of left atrial size and function. PAF was diagnosed by 7-day Holter monitoring. RESULTS: In 26 patients with PAF, late diastolic Doppler (A) and tissue Doppler (a') velocities were lower whereas left atrial diameter, left atrial volume index (LAVI), LAVI/A, and LAVI/a' were larger (P<0.05 for all) than they were in 167 patients without PAF. In multivariate models A, a', LAVI/A, and LAVI/a' predicted the presence of PAF. Area under the receiver operating characteristic curve to diagnose PAF was highest for LAVI/a' (0.813 [0.738; 0.889]). A previously suggested cut-off of LAVI/a'<2.3 had 92% sensitivity, 55.8% specificity, and 98% negative predictive value for PAF. CONCLUSIONS: LAVI/a'<2.3 can effectively rule out PAF in patients with cerebral ischemia.
Authors: Karl Georg Haeusler; Klaus Gröschel; Martin Köhrmann; Stefan D Anker; Johannes Brachmann; Michael Böhm; Hans-Christoph Diener; Wolfram Doehner; Matthias Endres; Christian Gerloff; Hagen B Huttner; Manfred Kaps; Paulus Kirchhof; Darius Günther Nabavi; Christian H Nolte; Waltraud Pfeilschifter; Burkert Pieske; Sven Poli; Wolf Rüdiger Schäbitz; Götz Thomalla; Roland Veltkamp; Thorsten Steiner; Ulrich Laufs; Joachim Röther; Rolf Wachter; Renate Schnabel Journal: Clin Res Cardiol Date: 2018-04-27 Impact factor: 5.460
Authors: Shadi Yaghi; Yeseon P Moon; Consuelo Mora-McLaughlin; Joshua Z Willey; Ken Cheung; Marco R Di Tullio; Shunichi Homma; Hooman Kamel; Ralph L Sacco; Mitchell S V Elkind Journal: Stroke Date: 2015-04-23 Impact factor: 7.914
Authors: Shadi Yaghi; Amelia K Boehme; Rebecca Hazan; Eldad A Hod; Alberto Canaan; Howard F Andrews; Hooman Kamel; Randolph S Marshall; Mitchell S V Elkind Journal: J Stroke Cerebrovasc Dis Date: 2015-10-21 Impact factor: 2.136