Left Atrial Dilatation and Reduced Left Ventricular Ejection Fraction Are Associated With Cardioembolic Stroke

Area of Science:

• Cardiology
• Neurology
• Medical Imaging

Background:

• Left atrial (LA) dilatation and reduced left ventricular ejection fraction (EF) are independent risk factors for ischemic stroke.
• Cardioembolic stroke, a significant cause of morbidity and mortality, often originates from cardiac sources.

Purpose of the Study:

• To evaluate the association between LA dilatation and reduced EF with cardioembolic stroke.
• To determine if combined LA dilatation and reduced EF predict atrial fibrillation (Afib) and cardioembolic stroke.

Main Methods:

• Retrospective study of 453 ischemic stroke patients with echocardiograms.
• Stroke categorized as cardioembolic or non-cardioembolic.
• LA volume and EF categorized into normal and abnormal ranges; hypertension and Afib history recorded.

Main Results:

• Patients with cardioembolic stroke had significantly higher rates of reduced EF (22.4% vs. 8.1%) and enlarged LA (65% vs. 27.7%) compared to non-cardioembolic stroke patients (p < 0.0001).
• Odds of cardioembolic stroke were 2.0 and 8.8 times higher with moderately and severely reduced EF, respectively.
• Enlarged LA increased cardioembolic stroke odds by 2.4 times (p < 0.0001).
• Combined LA dilatation and reduced EF showed significantly higher rates of Afib (43.4% vs. 9.0%) and cardioembolic stroke (78.3% vs. 43.4%) (p < 0.0001).

Conclusions:

• LA dilatation and reduced EF are reliable predictors of Afib and cardioembolic stroke.
• The combination of LA dilatation and reduced EF identifies a high-risk population for cardioembolic stroke.
• Further research is warranted to explore anticoagulation benefits for secondary stroke prevention in this patient group.