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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

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Ratio of Left Atrial and Ventricular Volume as New Marker of Atrial Cardiopathy and Stroke Risk

Julian Deseoe1,2, Martin Hänsel1, Lisa Herzog1

  • 1Department of Neurology and Clinical Neuroscience Center, University Hospital Zürich and University of Zürich, Switzerland (J.D., M.H., L.H., A.R.L., S.W.).

Stroke
|June 18, 2026
PubMed

Insights

The left atrial to ventricular volume (LA:LV) ratio is a superior marker for atrial cardiopathy compared to left atrial volume indexed to body surface area (LAVi). This novel ratio improves stroke risk prediction and cognitive function assessment.

Area of Science:

  • Cardiology
  • Neurology
  • Biomarker Research

Background:

  • Atrial cardiopathy is a significant cause of embolic stroke and cognitive impairment.
  • Left atrial volume indexed to body surface area (LAVi) is a common but non-specific marker.
  • The left atrial to ventricular volume (LA:LV) ratio offers improved specificity for pathological atrial remodeling.

Purpose of the Study:

  • To evaluate the LA:LV ratio as a more specific marker for atrial cardiopathy.
  • To compare the association of LA:LV ratio and LAVi with ischemic stroke risk and cognitive function.
  • To assess the utility of LA:LV ratio in identifying atrial fibrillation/flutter as a cause of stroke.

Main Methods:

  • Analysis of two cohorts: UK Biobank (n=38,848) and ischemic stroke patients (n=1273).
  • Competing risks survival analysis for stroke risk and linear regression for cognitive function.
  • Comparison of LA:LV ratio and LAVi in identifying atrial fibrillation/flutter in stroke patients.

Main Results:

  • LA:LV ratio, unlike LAVi, was significantly associated with increased ischemic stroke/transient ischemic attack risk.
  • LA:LV ratio demonstrated a stronger association with worse cognitive function.
  • LA:LV ratio significantly outperformed LAVi in identifying atrial fibrillation/flutter as a cause of ischemic stroke.

Conclusions:

  • The LA:LV ratio is a robust, novel marker for atrial cardiopathy.
  • This ratio has the potential to enhance the diagnosis of atrial cardiopathy.
  • Improved diagnosis can facilitate ischemic stroke prophylaxis and brain health maintenance.
Abstract

Keywords:
atrial fibrillationbody surface areacardiac volumecognitionetiologyheart atriaischemic stroke

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