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Updated: May 6, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Left atrial volumes and associated stroke subtypes.
Quratulain Shaikh, Bilal Ahmed, Maryam Ahmed
1The International Cerebrovascular Translational Clinical Research Training Program, Stroke Services, Aga Khan University, Karachi, Pakistan. ayeesha.kamal@aku.edu.
Left atrial volume indices help differentiate stroke mechanisms. Mild increases indicate higher risk of atherosclerotic stroke, while further increases shift risk toward cardioembolic stroke.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Cardio embolism and cerebrovascular atherosclerosis are primary stroke mechanisms.
- Limited research exists on advanced echocardiographic parameters and stroke mechanisms.
Purpose of the Study:
- To investigate the association between advanced echocardiographic parameters and stroke mechanisms.
- To determine if left atrial volume indices can differentiate between cardioembolic and atherothrombotic stroke.
Main Methods:
- Standardized review of 633 stroke patients.
- Stroke subtypes classified using the Causative Classification System (CCS).
- Exclusion of patients with multiple stroke mechanisms.
Main Results:
- Cardioembolic stroke patients showed higher rates of atrial fibrillation, myocardial infarction, and ischemic heart disease.
- Elevated left atrial volume indices (LAVi) were associated with cardioembolic stroke.
- LAVi of 29-33 ml/m2 increased atherothrombotic stroke risk; LAVi ≥34 ml/m2 increased cardioembolic stroke risk.
Conclusions:
- Left atrial volume indices correlate with specific stroke phenotypes.
- Mild increases in left atrial dimensions suggest higher risk of atherosclerotic stroke, potentially linked to hypertension.
- Significant increases in left atrial dimensions are associated with an increased risk of cardioembolic stroke.
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