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Left Atrial Enlargement is Associated with Stroke Severity with Cardioembolic and Cryptogenic Subtypes in a Chinese

Jie Xue1, Xu-Shen Xu1, Xiao-Qiong Zhu1

  • 1Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|March 17, 2020
PubMed

Insights

Left atrial enlargement is linked to more severe ischemic strokes, particularly cardioembolic and cryptogenic types. This finding highlights the importance of assessing left atrial size in stroke patients.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Left atrial enlargement is a known risk factor for stroke.
  • Limited research exists on the correlation between left atrial size and ischemic stroke severity.
  • This study investigates the association in the Chinese population.

Purpose of the Study:

  • To evaluate the association between left atrial size and stroke severity.
  • To specifically examine this relationship in cardioembolic and cryptogenic stroke subtypes.
  • To assess the predictive value of left atrial size for stroke severity in Chinese patients.

Main Methods:

  • 1271 patients with acute ischemic stroke were analyzed.
  • Echocardiographic left atrial diameter was measured and indexed to height.
  • Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), with moderate-to-severe defined as NIHSS ≥ 5. Left atrial size was categorized into tertiles. Binary logistic regression was employed.

Main Results:

  • 25.8% of patients had moderate-to-severe stroke (NIHSS ≥ 5).
  • In the overall cohort, the highest tertile of left atrial size was not significantly associated with moderate-to-severe stroke (OR=0.902, P=.550).
  • Among 190 patients with cardioembolic and cryptogenic stroke, 36.8% had moderate-to-severe stroke. The highest tertile of left atrial size was significantly associated with moderate-to-severe stroke (OR=3.156, P=.027) after adjustment.

Conclusions:

  • Left atrial enlargement is associated with more severe initial neurologic deficits in patients with acute ischemic stroke.
  • This association is particularly significant for embolic stroke subtypes, including cardioembolic and cryptogenic stroke.
  • Left atrial size is an important imaging marker for predicting stroke severity in specific patient groups.
Abstract

Keywords:
Left atrial sizeNIHSScardioembolic and cryptogenic strokestroke severity

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