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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

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Tissue Doppler index, E/E', and ischemic stroke in patients with atrial fibrillation and preserved left ventricular

Sang-Hak Lee1, Seonghoon Choi, Wook-Jin Chung

  • 1Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Republic of Korea.

Journal of the Neurological Sciences
|May 27, 2008
PubMed

Insights

Left ventricular diastolic dysfunction, indicated by E/E' ratio, is a significant predictor of ischemic stroke in atrial fibrillation (AF) patients. This finding highlights the importance of diastolic function assessment in stroke risk stratification.

Area of Science:

  • Cardiology
  • Neurology
  • Echocardiography

Background:

  • Stroke risk factors in atrial fibrillation (AF) are known, but the role of left ventricular (LV) diastolic dysfunction remains unclear.
  • This study investigates the association between LV diastolic dysfunction, assessed by the E/E' ratio, and ischemic stroke in AF patients.

Purpose of the Study:

  • To evaluate the relationship between the tissue Doppler-derived index E/E', other clinical, and echocardiographic parameters and ischemic stroke in patients with persistent AF.
  • To identify independent predictors of ischemic stroke in this population.

Main Methods:

  • A cross-sectional study included 330 patients with persistent AF and preserved LV ejection fraction from 6 centers.
  • Clinical data and transthoracic echocardiography were performed. Patients were divided into those with (n=50) and without (n=280) a history of ischemic stroke.
  • Logistic regression analyses were used to identify potential determinants of ischemic stroke.

Main Results:

  • Univariate analyses showed significant correlations between ischemic stroke and age, hypertension, diabetes, hyperlipidemia, heart failure, BNP, E, E', and E/E'.
  • Multivariate regression identified hypertension (OR=6.03, p=0.008) and E/E' (OR=1.21, p=0.002) as independent predictors of ischemic stroke.

Conclusions:

  • LV diastolic dysfunction, as reflected by the E/E' ratio, is a significant determinant of ischemic stroke in patients with AF.
  • The E/E' ratio may have clinical implications for stroke risk stratification in AF patients.
  • Further prospective studies are needed to confirm the utility of E/E' in risk stratification.
Abstract

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