Related Experiment Video
Updated: Nov 11, 2025
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Left Atrial Appendage Flow Velocity and Multiple Infarcts in Cryptogenic Stroke
Keisuke Tokunaga1, Go Hashimoto1, Tadataka Mizoguchi1
1Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Insights
Reduced left atrial appendage flow velocity (LAA-FV) is linked to multiple infarcts in cryptogenic stroke patients. This suggests LAA dysfunction contributes to embolic stroke in these cases.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Cryptogenic stroke often presents with multiple infarcts.
- A hypothesis suggests embolic origins due to left atrial appendage (LAA) dysfunction.
Purpose of the Study:
- To investigate the association between LAA flow velocity (LAA-FV) and multiple infarcts in cryptogenic stroke patients.
- To validate the role of LAA dysfunction in embolic stroke.
Main Methods:
- Retrospective observational study of 786 cryptogenic stroke patients.
- Assessed infarct multiplicity using diffusion-weighted MRI.
- Measured LAA peak emptying flow velocity (LAA-FV) via transesophageal echocardiography (TEE).
Main Results:
- 34% of patients had multiple infarcts.
- Multiple infarcts decreased with increasing LAA-FV quartiles (p<0.001).
- Higher LAA-FV was associated with a lower risk of multiple infarcts (aOR 0.39 in the highest quartile).
Conclusions:
- Reduced LAA-FV is associated with multiple infarcts in cryptogenic stroke.
- Findings support LAA dysfunction as a cause of embolic stroke in cryptogenic stroke with multiple infarcts.
Background:
To validate the hypothesis that cryptogenic stroke with multiple infarcts included embolic stroke due to left atrial appendage (LAA) dysfunction, the present retrospective observational study was aimed to clarify the association between LAA flow velocity (LAA-FV) and multiple infarcts in patients with cryptogenic stroke.
Methods:
From consecutive patients with cryptogenic stroke admitted to our hospital within 7 days after onset, patients without brain magnetic resonance imaging (MRI) on admission or without transesophageal echocardiography (TEE) during acute hospitalization were excluded, and the remaining patients were enrolled. Multiplicity of fresh infarcts was assessed using diffusion-weighted images from brain MRI. LAA-FV was defined as LAA peak emptying flow velocity on TEE.
Results:
Of 786 enrolled patients, 522 patients (66%) had a single infarct, and the remaining 264 patients (34%) had multiple infarcts. The percentage of multiple infarcts decreased with increasing quartiles of LAA-FV (p for trend <0.001). The adjusted odds ratio for multiple infarcts decreased with increasing quartiles of LAA-FV (adjusted odds ratio in the fourth quartile, 0.39; 95% confidence interval, 0.25-0.60; compared with the first quartile). LAA-FV as a continuous variable was negatively associated with multiple infarcts (adjusted odds ratio per 10 cm/s, 0.87; 95% confidence interval, 0.81-0.92).
Conclusions:
Reduced LAA-FV on TEE was associated with multiple infarcts in patients with cryptogenic stroke. The present findings indicate that cryptogenic stroke with multiple infarcts includes embolic stroke due to LAA dysfunction.
More Related Videos
06:29Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
04:48Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018