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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Combined Brain-Cardiac CT in Ischemic Stroke: Unveiling Atrial Markers Linked to Large Vessel Occlusion in AF

Soundous M'Rabet1,2, Gauthier Duloquin2,3, Pierre-Antoine Garbuio4

  • 1Cardiology Department, University Hospital, Dijon, France.

European Journal of Neurology
|July 7, 2025
PubMed

Insights

Atrial fibrillation patients with larger left atrial volume (LAV) and female sex are more likely to experience large vessel occlusion (LVO) strokes. This highlights atrial cardiomyopathy

Area of Science:

  • Cardiology
  • Neurology
  • Radiology

Background:

  • Atrial fibrillation (AF) significantly increases ischemic stroke risk, especially large vessel occlusion (LVO).
  • Atrial cardiomyopathy (AtCM) severity may differentiate LVO from distal cardioembolic strokes in AF patients.
  • Investigating AtCM markers on acute brain-cardiac CT could predict LVO in AF stroke patients.

Purpose of the Study:

  • To determine if AtCM markers on acute brain-cardiac CT are associated with LVO in AF patients with ischemic stroke.
  • To identify predictors of LVO in the AF stroke population.

Main Methods:

  • Analysis of 619 ischemic stroke patients (Nov 2018-Mar 2021) at Dijon University Hospital.
  • Cardiac CT assessment of left atrium volume (LAV), thrombus, and epicardial adipose tissue.
  • Stratification of patients based on LVO status.

Main Results:

  • Of 248 AF patients, 138 (56%) had LVO.
  • LVO patients exhibited higher NIHSS scores and more frequent IV thrombolysis.
  • Higher LAV (112.0±43.0 cm³ vs. 100.1±39.0 cm³) was observed in LVO patients (p=0.026).
  • Female sex (OR 1.98) and LAV > 90 mL (OR 2.02) independently predicted LVO.

Conclusions:

  • Larger LAV and female sex are independent predictors of LVO in AF patients.
  • These findings underscore the role of AtCM in stroke pathophysiology.
  • Further research is warranted for prevention strategies in high-risk AF patients.
Abstract

Keywords:
CT scanatrial cardiomyopathyatrial fibrillationlarge vessel occlusionstroke

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