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Left Atrial Expansion Index for Ischemic Stroke Prediction in Patients with Atrial Fibrillation

Jau-Wen Shiau1, Chao-Sheng Hsiao2,3, Shih-Hung Hsiao3

  • 1Department of Mechanical Engineering, National Chung Hsing University, Taichung.

Acta Cardiologica Sinica
|January 24, 2024
PubMed

Insights

The left atrial expansion index (LAEI) can predict ischemic stroke in patients with atrial fibrillation (AF). Lower LAEI values indicate a higher risk of stroke, making it a valuable diagnostic tool.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Atrial fibrillation (AF) is a common arrhythmia associated with an increased risk of ischemic stroke.
  • Predictive markers for stroke in AF patients are crucial for risk stratification and management.
  • The utility of the left atrial expansion index (LAEI) in predicting these events remains unclear.

Purpose of the Study:

  • To investigate the efficacy of the left atrial expansion index (LAEI) in predicting cerebral ischemic events in patients with atrial fibrillation (AF).
  • To determine the association between LAEI and stroke incidence in a cohort of AF patients.

Main Methods:

  • 177 patients with AF underwent comprehensive echocardiography to calculate LAEI.
  • Patients were followed for a mean of 9.9 years to ascertain stroke occurrence (ischemic stroke, TIA).
  • Statistical analyses, including multivariable analysis, were performed to assess the predictive value of LAEI.

Main Results:

  • 44 patients (24.9%) experienced a stroke during follow-up.
  • Lower LAEI values were significantly associated with a higher incidence of stroke.
  • An LAEI < 35% demonstrated 77% sensitivity and 78% specificity for predicting stroke.
  • LAEI was an independent predictor of ischemic stroke (HR 0.952 per 1% increase, p < 0.0001).

Conclusions:

  • The left atrial expansion index (LAEI) is a valuable and independent predictor of ischemic stroke in patients with atrial fibrillation.
  • LAEI measurement via echocardiography can aid in identifying high-risk AF patients who may benefit from closer monitoring or intervention.
Abstract

Keywords:
Atrial fibrillationIschemic strokeLeft atrial expansion index

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