Timolaos Rizos1, Solveig Horstmann2, Felix Dittgen2, Tobias Täger2, Ekkehart Jenetzky2, Peter Heuschmann2, Roland Veltkamp2. 1. From the Departments of Neurology (T.R., S.H., F.D., R.V.) and Cardiology (T.T.), University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany (E.J.); Department for Child and Adolescent Psychiatry, Johannes Gutenberg-University, Mainz, Germany (E.J.); Department of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany (P.H.); and Department of Stroke Medicine, Imperial College London, London, United Kingdom (R.V.). Timolaos.rizos@med.uni-heidelberg.de. 2. From the Departments of Neurology (T.R., S.H., F.D., R.V.) and Cardiology (T.T.), University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany (E.J.); Department for Child and Adolescent Psychiatry, Johannes Gutenberg-University, Mainz, Germany (E.J.); Department of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany (P.H.); and Department of Stroke Medicine, Imperial College London, London, United Kingdom (R.V.).
Abstract
BACKGROUND AND PURPOSE: Whether newly diagnosed atrial fibrillation (nAF) after stroke reflects underlying heart disease and represents an increased risk of cardioembolic stroke, or whether it is triggered by neurogenic mechanisms remains uncertain. We investigated, whether cardiovascular risk factors and echocardiographic parameters in patients with nAF are similar to patients with known AF (kAF) and differ from patients without AF. METHODS: Consecutive acute ischemic stroke patients were enrolled into a prospective stroke database. All patients with echocardiography were included and univariable and multivariable testing was applied to compare clinical characteristics and echocardiographic findings among patients with nAF, kAF, and no AF. RESULTS: A total of 1397 patients were included (male, 62.3%; median age, 71 years). AF was present in 320 (22.9%) patients. Of those, nAF was present in 36.2% (116/320) and kAF in 63.8% (204/320). No clinical or echocardiographic factor was independently associated with detection of nAF compared with kAF but a trend toward larger left atrial diameters in patients with kAF was observed (P=0.070). In contrast, patients with nAF were more often female (P<0.001), older (P<0.001) and had a larger left atrial diameters (P<0.001) compared with patients without AF. While stroke severity in patients with nAF and kAF was similar, patients without AF had less severe strokes. CONCLUSIONS: Stroke patients with nAF and with kAF share common cardiovascular risk factors, have similar echocardiographic findings and suffer equally severe strokes. We conclude that preexisting heart disease is the major cause of AF that is first diagnosed after stroke.
BACKGROUND AND PURPOSE: Whether newly diagnosed atrial fibrillation (nAF) after stroke reflects underlying heart disease and represents an increased risk of cardioembolic stroke, or whether it is triggered by neurogenic mechanisms remains uncertain. We investigated, whether cardiovascular risk factors and echocardiographic parameters in patients with nAF are similar to patients with known AF (kAF) and differ from patients without AF. METHODS: Consecutive acute ischemic strokepatients were enrolled into a prospective stroke database. All patients with echocardiography were included and univariable and multivariable testing was applied to compare clinical characteristics and echocardiographic findings among patients with nAF, kAF, and no AF. RESULTS: A total of 1397 patients were included (male, 62.3%; median age, 71 years). AF was present in 320 (22.9%) patients. Of those, nAF was present in 36.2% (116/320) and kAF in 63.8% (204/320). No clinical or echocardiographic factor was independently associated with detection of nAF compared with kAF but a trend toward larger left atrial diameters in patients with kAF was observed (P=0.070). In contrast, patients with nAF were more often female (P<0.001), older (P<0.001) and had a larger left atrial diameters (P<0.001) compared with patients without AF. While stroke severity in patients with nAF and kAF was similar, patients without AF had less severe strokes. CONCLUSIONS:Strokepatients with nAF and with kAF share common cardiovascular risk factors, have similar echocardiographic findings and suffer equally severe strokes. We conclude that preexisting heart disease is the major cause of AF that is first diagnosed after stroke.
Authors: Timolaos Rizos; Andreas J Bartsch; Timothy D Johnson; Felix Dittgen; Thomas E Nichols; Uwe Malzahn; Roland Veltkamp Journal: PLoS One Date: 2017-05-24 Impact factor: 3.240
Authors: Renate B Schnabel; Stephan Camen; Fabian Knebel; Andreas Hagendorff; Udo Bavendiek; Michael Böhm; Wolfram Doehner; Matthias Endres; Klaus Gröschel; Andreas Goette; Hagen B Huttner; Christoph Jensen; Paulus Kirchhof; Grigorios Korosoglou; Ulrich Laufs; Jan Liman; Caroline Morbach; Darius Günther Nabavi; Tobias Neumann-Haefelin; Waltraud Pfeilschifter; Sven Poli; Timolaos Rizos; Andreas Rolf; Joachim Röther; Wolf Rüdiger Schäbitz; Thorsten Steiner; Götz Thomalla; Rolf Wachter; Karl Georg Haeusler Journal: Clin Res Cardiol Date: 2021-06-18 Impact factor: 5.460