Left Atrial Enlargement in Primary Cryptogenic Strokes Without Atrial Fibrillation.

Area of Science:

• Cardiology
• Neurology
• Echocardiography

Background:

• Left atrial enlargement (LAE) is a potential risk factor for various cardiovascular events, including stroke.
• The specific role of LAE in primary cryptogenic stroke (PCS) remains unclear, especially when atrial fibrillation is absent.

Purpose of the Study:

• To investigate the prevalence of LAE in patients diagnosed with PCS, excluding those with known causes of stroke like atrial fibrillation.
• To determine if LAE is an independent risk factor for PCS.

Main Methods:

• A multi-center, retrospective, cross-sectional study analyzed 154 patients with cerebral infarction and no other identified stroke causes.
• Left atrial enlargement was diagnosed using transthoracic echocardiogram criteria, including left atrial diameter (LAD) and left atrial volume index (LAVI).
• Logistic regression modeling was employed to assess correlations.

Main Results:

• Nearly half (48%) of the study cohort met criteria for LAE.
• Patients with LAE had significantly larger mean LAD (4.1 cm vs 3.4 cm) and LAVI (29.68 mL/m² vs 18.44 mL/m²) compared to those without.
• Common comorbidities included hypertension (70%), tobacco use (52%), and diabetes (31%).

Conclusions:

• Left atrial enlargement is a significant risk factor in patients with primary cryptogenic stroke.
• Findings underscore the importance of screening for LAE in PCS patients and managing associated risk factors like hypertension, diabetes, and tobacco use.
• Further research, including randomized trials, is needed to clarify the clinical implications of LAE in PCS and guide prophylactic strategies.