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Left atrial septal pouch in cryptogenic stroke.

Jonathan M Wong1, Dawn M Lombardo2, Ailin Barseghian2

  • 1Department of Medicine, California Pacific Medical Center , San Francisco, CA , USA.

Frontiers in Neurology
|April 9, 2015
PubMed
Summary

The left atrial septal pouch (LASP) is more common in cryptogenic stroke patients. This anatomical variant may be linked to cryptogenic strokes, warranting further investigation in larger studies.

Keywords:
cryptogenic strokeischemic stroketransesophageal echocardiography

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Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • The left atrial septal pouch (LASP) is an anatomical variation of the interatrial septum with unclear clinical implications.
  • Understanding the association between LASP and stroke is crucial for patient management.

Purpose of the Study:

  • To investigate the relationship between the presence of LASP and different subtypes of ischemic stroke.
  • To determine if LASP is more prevalent in cryptogenic strokes compared to other ischemic stroke types.

Main Methods:

  • A retrospective analysis of patients undergoing transesophageal echocardiography (TEE).
  • Prevalence of LASP was determined in patients with ischemic stroke, cryptogenic stroke, and non-stroke controls.
  • Stroke subtypes were classified using standard and modified Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria.

Main Results:

  • The overall prevalence of LASP was 17% in the study population.
  • LASP prevalence was significantly higher in patients with cryptogenic stroke (26-30%) compared to other ischemic stroke subtypes (9-10%).
  • Prevalence ratios (PR) indicated a 1.8 to 2.2 times increased likelihood of LASP in cryptogenic stroke patients.

Conclusions:

  • The study suggests an association between LASP and cryptogenic stroke, particularly in a younger patient cohort.
  • LASP may be a contributing factor or marker for cryptogenic strokes.
  • Further large-scale research is recommended to confirm these findings and elucidate the underlying mechanisms.