Cardiac imaging correlates and predictors of stroke in patients with atrial fibrillation: a meta-analysis

Area of Science:

• Cardiology
• Medical Imaging
• Thrombosis Research

Background:

• Current stroke risk stratification for atrial fibrillation (AF) patients requires novel nonclinical parameters.
• Cardiac imaging may offer valuable insights into predicting stroke or systemic embolism in AF.

Approach:

• A comprehensive meta-analysis was conducted, pooling data from 64 studies.
• Searched MEDLINE, EMBASE, and Web of Science for relevant studies up to November 2022.
• Employed random effects meta-analysis to synthesize findings.

Key Points:

• Left atrial spontaneous echo-contrast, non-chicken wing left atrial appendage (LAA) morphology, left atrial enlargement, and larger LAA orifice diameter strongly correlate with stroke.
• Other identified predictors include increased left atrial sphericity, volume, and volume index; reduced left atrial reservoir strain; elevated left ventricular mass index; and higher E/e' ratio.
• Left atrial appendage volume did not show a significant association with stroke risk.

Conclusions:

• Identified cardiac imaging parameters show promise in enhancing stroke risk prediction accuracy for AF patients.
• Future research should focus on integrated risk scores combining clinical factors, biomarkers, and imaging data.
• These findings can refine clinical decision-making for AF-related thromboembolism prevention.