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Left atrial appendage function in patients with cardioembolic stroke in sinus rhythm and atrial fibrillation
N Ozer1, L Tokgözoğlu, K Ovünç
1Hacettepe University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey.
Insights
Reduced left atrial appendage (LAA) flow velocity is a stroke risk factor, especially in patients with sinus rhythm. LAA enlargement primarily occurs in patients with atrial fibrillation.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- The left atrial appendage (LAA) plays a role in stroke pathogenesis.
- Understanding LAA function is crucial for identifying stroke risk factors.
Purpose of the Study:
- To investigate left atrial appendage (LAA) function in patients who have experienced a stroke.
- To correlate LAA function parameters with stroke occurrence in different cardiac rhythm groups.
Main Methods:
- Echocardiography was used to assess LAA flow velocities and dimensions.
- Stroke patients were categorized into groups based on atrial fibrillation or sinus rhythm.
- Comparison of LAA parameters between stroke patients and control subjects.
Main Results:
- Patients with atrial fibrillation exhibited significantly reduced LAA flow velocities and enlarged LAA areas.
- Patients with stroke in sinus rhythm showed reduced LAA flow velocities but no significant LAA enlargement.
- Decreased LAA flow velocity was identified as a risk factor for stroke in patients with sinus rhythm.
Conclusions:
- Reduced LAA flow velocity is a significant risk factor for stroke, particularly in patients with sinus rhythm and normal LAA size.
- LAA enlargement is predominantly associated with atrial fibrillation in stroke patients.
Abstract:
The purpose of this study was to determine the left atrial appendage (LAA) function in patients with stroke. The study group consisted of 61 patients with stroke and 37 control subjects. Patients with stroke were divided into 2 groups on the basis of the presence of atrial fibrillation (group 1) or sinus rhythm (group 2). Group 1 showed a significant reduction of LAA flow velocities (13.2 +/- 6.4 cm/s versus 27.5 +/- 8 cm/s, P <.05) and significant increase in LAA areas (minimum area: 360.5 +/- 204 mm(2) versus 217.7 +/- 113.9 mm(2), P =.004). Group 2 showed a decrease in LAA flow velocities (17.7 +/- 8.2 cm/s versus 27.5 +/- 8 cm/s, P <.05), but no significant change was found in LAA areas. No significant difference was found in other parameters related to LAA. These findings show that a decreased LAA flow velocity is a risk factor for stroke in patients in sinus rhythm without LAA enlargement. Left atrial appendage area was increased in size only in patients with atrial fibrillation.