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The Influence of Left Atrial Enlargement on the Relationship between Atrial Fibrillation and Stroke

Stephen T Broughton1, Wesley T O'Neal1, Taufiq Salahuddin1

  • 1Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|March 26, 2016
PubMed

Insights

Left atrial enlargement (LAE) does not increase stroke risk in patients with atrial fibrillation (AF). Echocardiographic LAE does not modify the stroke risk associated with AF.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Left atrial enlargement (LAE) is an independent risk factor for stroke and atrial fibrillation (AF).
  • The combined effect of LAE and AF on stroke risk requires further investigation.

Purpose of the Study:

  • To investigate whether left atrial enlargement modifies the association between atrial fibrillation and ischemic stroke risk.

Main Methods:

  • Analysis of 4572 participants from the Cardiovascular Health Study.
  • LAE assessed via echocardiography; AF identified via ECG and medical history.
  • Ischemic stroke events identified through medical record adjudication over a median follow-up of 13 years.

Main Results:

  • Atrial fibrillation (AF) and increased left atrial diameter were independently associated with higher ischemic stroke risk.
  • Participants with AF were more likely to have LAE.
  • The presence of LAE did not significantly alter the increased stroke risk associated with AF (P interaction = .86).

Conclusions:

  • Echocardiographic assessment of left atrial enlargement does not modify the stroke risk observed in patients with atrial fibrillation.
  • These findings suggest that AF is the primary driver of increased stroke risk in this population.
Abstract

Keywords:
Left atriumatrial fibrillationechocardiographystroke

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