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Published on: July 20, 2022
Are left atrial abnormalities a risk for stroke?
Amanj J Khidhir1, Ehsan K Al-Shimmery, Mohammed H Alwan
1Department of Medicine, Rizgary Teaching Hospital, Erbil, Iraq.
Insights
Electrocardiographic left atrial abnormalities (ECG-LAA) are linked to ischemic stroke, while echocardiographic left atrial enlargement (Echo-LAE) affects both ischemic and hemorrhagic stroke types equally. These findings suggest potential new risk factors for stroke.
Area of Science:
- Cardiology
- Neurology
- Medical Diagnostics
Background:
- Left atrial abnormalities are increasingly recognized as potential indicators of cardiovascular risk.
- Understanding the relationship between cardiac morphology/function and stroke subtypes is crucial for risk stratification.
Purpose of the Study:
- To investigate echocardiographic left atrial enlargement (Echo-LAE) and electrocardiographic left atrial abnormalities (ECG-LAA) as potential novel risk factors for ischemic and hemorrhagic stroke.
- To determine the prevalence and association of ECG-LAA and Echo-LAE in stroke patients.
Main Methods:
- A prospective case study of 140 patients with confirmed ischemic or hemorrhagic stroke.
- Standard 12-lead ECG and 2D transthoracic echocardiography were performed.
- ECG-LAA defined by P terminal force in V1 (PTFV1) >40 mm.ms; Echo-LAE defined by left atrial index >2.3 cm/m².
Main Results:
- ECG-LAA was significantly more prevalent in ischemic stroke patients compared to hemorrhagic stroke patients.
- Common causes for ECG-LAA included hypertension, advanced age, and coronary artery disease.
- Echo-LAE was observed in 34% of ischemic and 30% of hemorrhagic strokes, with no significant difference between the groups.
Conclusions:
- ECG-LAA is significantly associated with ischemic stroke but may not be an independent risk factor due to frequent co-occurrence with other risk factors.
- Echo-LAE shows equal association with both ischemic and hemorrhagic stroke, indicating its potential role in the pathophysiology of both stroke types.
Objectives:
To show that echocardiographic left atrial enlargement (Echo-LAE) and electrocardiographic left atrial abnormalities (ECG-LAA) may be probable new risk factors for ischemic and hemorrhagic stroke.
Methods:
This descriptive prospective case study included 140 CT or MRI-confirmed hemorrhagic and ischemic stroke patients, who were admitted to Rizgary Teaching Hospital, Erbil, Iraq from January 2008 to January 2009. Twelve lead ECG and 2-dimensional transthoracic Echo were performed for all patients. Electrocardiographic LAA were identified when the P terminal force in lead V1 (PTFV1) was >40 mm.ms. Echocardiographic LAE was identified when the left atrial index was more than 2.3 cm/m2.
Results:
Electrocardiographic LAA we resignificantly higher in ischemic stroke patients in comparison with the hemorrhagic strokes. Causes of ECG-LAA were found to be as follows in order of frequency; hypertension (56%), advanced age (47%), coronary artery disease (27%), diabetes mellitus (26%), obesity (21%), valvular heart disease (21%), and 2.6% of patients had no identifiable cause. Echocardiographic-LAE was seen in 34% of ischemic strokes, and 30% of hemorrhagic strokes with no significant difference.
Conclusion:
Although ECG-LAA (PTFV1>40 mm.ms) is significantly associated with ischemic stroke, it may not be an independent risk factor for stroke as it rarely occurred without other risk factors. Echocardiographic LAE i s associated with both ischemic and hemorrhagic strokes equally.
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