Transthoracic Transmitral Atrial Flow is Independently Associated with Ischemic Stroke Risk in Paroxysmal Atrial...

Area of Science:

• Cardiology
• Echocardiography
• Stroke Prevention

Background:

• Atrial fibrillation (AF) is a significant risk factor for ischemic stroke.
• Non-invasive assessment of stroke risk in AF patients is crucial.

Purpose of the Study:

• To evaluate if transmitral atrial flow velocity (MVA), measured via transthoracic echocardiography (TTE), predicts stroke risk in AF patients.
• To determine MVA's value in refining stroke risk stratification, particularly in low-risk AF populations.

Main Methods:

• A cohort study of 10,150 paroxysmal AF patients from 2010-2021.
• Primary outcome: hospitalization for ischemic stroke.
• Multivariable Cox regression analyses adjusted for CHA2DS2-VASc scores were used to assess the association between MVA and stroke risk.

Main Results:

• A reduction in MVA velocity was independently associated with increased stroke incidence.
• Each 10 cm/s decrease in MVA conferred a 4% higher stroke risk (adjusted HR 0.96).
• Patients with MVA < 50 cm/s had a 39% higher stroke risk (adjusted HR 1.39), similar to those with higher CHA2DS2-VASc scores.

Conclusions:

• Transthoracic echocardiography-derived MVA is an independent predictor of stroke risk in paroxysmal AF.
• Integrating MVA into risk assessment enhances stratification for targeted stroke prevention.
• MVA is particularly valuable for risk assessment in low-risk AF populations.