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Echocardiographic measures of atrial function may predict atrial fibrillation in stroke patients

David Waldenhjort1,2, Piotr Sobocinski Doliwa1, Mahbubul Alam1

  • 1a Department of Clinical Sciences, Karolinska Institutet , Danderyd University Hospital Stockholm , Sweden ;

Scandinavian Cardiovascular Journal : SCJ
|May 19, 2016
PubMed

Insights

Echocardiography can predict undiagnosed atrial fibrillation (AF) in stroke patients. Left atrial volume index and tissue Doppler imaging measures of atrial contraction effectively identify silent AF.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Atrial fibrillation (AF) is a common cause of stroke, necessitating anticoagulant therapy.
  • Identifying undiagnosed AF in stroke patients is crucial for effective stroke prevention.

Purpose of the Study:

  • To evaluate the predictive value of echocardiography for detecting unknown atrial fibrillation (AF) in patients with a history of stroke or transient ischemic attack (TIA).

Main Methods:

  • A prospective study involving 174 stroke/TIA patients without diagnosed AF.
  • Echocardiographic evaluation included tissue Doppler imaging (TDI) to assess left atrial and left ventricular diastolic function.
  • AF screening was conducted over a 30-day period.

Main Results:

  • Fifteen patients (8.6%) were diagnosed with AF.
  • Patients with AF exhibited larger left atrial volume index (LAVI) and lower A' velocities compared to those without AF.
  • Echocardiographic parameters like LAVI and LAVI/A' ratios demonstrated significant predictive value for detecting AF (AUC 0.71-0.78).

Conclusions:

  • Left atrial volume index (LAVI) and atrial contraction measures via TDI can predict undiagnosed AF in post-stroke/TIA patients.
  • These echocardiographic findings may aid in the detection of silent AF, guiding anticoagulant treatment decisions.
Abstract

Keywords:
Atrial fibrillationechocardiographyischemic stroketissue Doppler imaging

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