BACKGROUND: Left atrial (LA) strain as a marker for discrimination of risk for stroke and transient ischemic attack (TIA) in patients with atrial fibrillation and low-risk CHADS(2) scores (≤1) has yet to be examined. METHODS: Patients with atrial fibrillation, stroke or TIA, and CHADS(2) scores ≤ 1 before their events were identified retrospectively from a large single-center stroke registry and compared with age-matched and gender-matched controls. Antihypertensive use and echocardiographic parameters including chamber volumes and left ventricular mass and LA peak negative and positive strain and strain rate were compared between groups. RESULTS: Fifty-seven patients meeting entry criteria were identified. Patients demonstrated significantly lower left ventricular ejection fractions, larger LA dimensions, and larger LA volume indexes (24.4 ± 11.9 vs 32.3 ± 13.3 mL/m(2), P = .012) compared with controls. Both peak negative LA strain (-3.2 ± 1.2% vs -6.9 ± 4.2%, P < .001) and peak positive LA strain (14 ± 11% vs 25 ± 12%, P < .001) were significantly reduced in patients compared with controls. Peak negative LA strain was significantly associated with stroke by binary logistic regression (odds ratio, 2.15; P < .001). CONCLUSIONS: In patients with low-risk CHADS(2) scores, atrial fibrillation, and stroke or TIA, reduced LA strain is a potentially sensitive maker for increased risk for stroke or TIA. These results suggest that LA strain may have potential as a tool for helping guide the decision for or against oral anticoagulation in this group of patients.
BACKGROUND: Left atrial (LA) strain as a marker for discrimination of risk for stroke and transient ischemic attack (TIA) in patients with atrial fibrillation and low-risk CHADS(2) scores (≤1) has yet to be examined. METHODS:Patients with atrial fibrillation, stroke or TIA, and CHADS(2) scores ≤ 1 before their events were identified retrospectively from a large single-center stroke registry and compared with age-matched and gender-matched controls. Antihypertensive use and echocardiographic parameters including chamber volumes and left ventricular mass and LA peak negative and positive strain and strain rate were compared between groups. RESULTS: Fifty-seven patients meeting entry criteria were identified. Patients demonstrated significantly lower left ventricular ejection fractions, larger LA dimensions, and larger LA volume indexes (24.4 ± 11.9 vs 32.3 ± 13.3 mL/m(2), P = .012) compared with controls. Both peak negative LA strain (-3.2 ± 1.2% vs -6.9 ± 4.2%, P < .001) and peak positive LA strain (14 ± 11% vs 25 ± 12%, P < .001) were significantly reduced in patients compared with controls. Peak negative LA strain was significantly associated with stroke by binary logistic regression (odds ratio, 2.15; P < .001). CONCLUSIONS: In patients with low-risk CHADS(2) scores, atrial fibrillation, and stroke or TIA, reduced LA strain is a potentially sensitive maker for increased risk for stroke or TIA. These results suggest that LA strain may have potential as a tool for helping guide the decision for or against oral anticoagulation in this group of patients.
Authors: Hirohiko Motoki; Kazuaki Negishi; Kenya Kusunose; Zoran B Popović; Mandeep Bhargava; Oussama M Wazni; Walid I Saliba; Mina K Chung; Thomas H Marwick; Allan L Klein Journal: J Am Soc Echocardiogr Date: 2014-09-23 Impact factor: 5.251
Authors: Ahmet Barutçu; Emine Gazi; Ahmet Temiz; Adem Bekler; Burak Altun; Bahadır Kırılmaz; Uğur Küçük Journal: Int J Cardiovasc Imaging Date: 2014-04-22 Impact factor: 2.357
Authors: Rocio Hinojar; Jose Luis Zamorano; MªAngeles Fernández-Méndez; Amparo Esteban; Maria Plaza-Martin; Ariana González-Gómez; Alejandra Carbonell; Luis Miguel Rincón; Jose Julio Jiménez Nácher; Covadonga Fernández-Golfín Journal: Int J Cardiovasc Imaging Date: 2019-01-31 Impact factor: 2.357
Authors: Mohammadali Habibi; Harjit Chahal; Anders Opdahl; Ola Gjesdal; Thomas M Helle-Valle; Susan R Heckbert; Robyn McClelland; Colin Wu; Steven Shea; Gregory Hundley; David A Bluemke; João A C Lima Journal: JACC Cardiovasc Imaging Date: 2014-05-07