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Updated: Jul 12, 2026

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

Published on: July 20, 2022

Electrical and Structural Atrial Remodeling Identifies a High-Risk Phenotype in Embolic Stroke of Undetermined Source

Niklas Bach1, Louisa Bauermeister1, Lisann Böhnke1

  • 1Department of Cardiology and Rhythmology, University Hospital St Josef Hospital Bochum, Germany.

JACC. Advances
|July 9, 2026
PubMed

Insights

Atrial remodeling in Embolic Stroke of Undetermined Source (ESUS) patients identifies a high-risk subgroup. Assessing electrical and structural atrial changes can predict adverse cardiovascular events in these patients.

Area of Science:

  • Cardiology
  • Neurology
  • Biomedical Engineering

Background:

  • Embolic Stroke of Undetermined Source (ESUS) has a high recurrence risk, but standard treatments lack clear superiority.
  • Atrial cardiomyopathy, involving electrical and structural atrial changes, may indicate a higher-risk ESUS population.

Purpose of the Study:

  • To assess electrical and structural atrial remodeling in ESUS patients.
  • To determine the association between atrial remodeling and adverse cardiovascular outcomes.

Main Methods:

  • Prospective study of 103 ESUS patients and 123 controls.
  • Evaluated NT-proBNP, ECG, and echocardiography.
  • Follow-up for at least 12 months for primary composite endpoint.

Main Results:

  • ESUS patients showed higher NT-proBNP, more interatrial block, and poorer left atrial function.
  • 28% of ESUS patients reached the primary endpoint within a median follow-up of 382 days.
  • NT-proBNP, interatrial block, E', left atrial volume index, and left atrial ejection fraction predicted outcomes.

Conclusions:

  • Multimodal atrial remodeling assessment identifies high-risk ESUS patients.
  • Atrial cardiomyopathy is clinically relevant for predicting adverse events.
  • Findings may inform future anticoagulation and rhythm management studies.
Abstract

Keywords:
NT-proBNPadvanced interatrial blockatrial cardiomyopathyelectrocardiographyembolic stroke of undetermined source

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