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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Patients With Undetermined Stroke Have Increased Atrial Fibrosis: A Cardiac Magnetic Resonance Imaging Study

Ana Catarina Fonseca1, Pedro Alves2, Nuno Inácio2

  • 1From the Department of Neurology (A.C.F., P.A., T.P.-e.-M., J.M.F.) and Department of Cardiology (A.G.A.), Hospital de Santa Maria, University of Lisbon, Portugal; Department of Neurology, Hospital Beatriz Ângelo, Loures, Portugal (N.I.); and Department of Neurology, Hospital Egas Moniz, Lisboa, Portugal (J.P.M., M.V.-B.). acfonseca@medicina.ulisboa.pt.

Stroke
|January 27, 2018
PubMed

Insights

Undetermined cause ischemic strokes may stem from left atrial (LA) disease. Cardiac MRI revealed higher LA fibrosis in these patients, suggesting atrial changes contribute to stroke risk.

Area of Science:

  • Cardiology
  • Neurology
  • Radiology

Background:

  • Ischemic stroke of undetermined cause may be linked to left atrial (LA) and left atrial appendage abnormalities.
  • These LA structural or functional changes can increase thromboembolism risk.

Purpose of the Study:

  • To compare the left atrium and left atrial appendage in ischemic stroke patients with different causes.
  • To investigate the association between LA phenotype and stroke etiology.

Main Methods:

  • Prospective study of 111 ischemic stroke patients.
  • Exclusion of patients with echocardiographically identified causal stroke factors (TOAST classification).
  • Cardiac magnetic resonance imaging (3-T) was used for LA and left atrial appendage assessment.

Main Results:

  • Patients with undetermined stroke cause showed a significantly higher percentage of LA fibrosis (P=0.03) compared to other stroke groups.
  • LA ejection fraction was lower in the undetermined cause group, though not statistically significant.
  • Atrial fibrosis levels were similar between patients with atrial fibrillation and those with undetermined stroke cause.

Conclusions:

  • The observed LA phenotype in patients with undetermined stroke cause supports the hypothesis of atrial disease contributing to stroke.
  • This finding may help reclassify some cryptogenic strokes.
Abstract

Keywords:
atrial fibrillationechocardiographymagnetic resonance imagingstrokethromboembolism

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