Value of Cardiac Structural Metrics in Identifying Cardioembolic Stroke: A Cross-Sectional Study

Area of Science:

• Cardiology
• Neurology
• Medical Imaging

Background:

• Detecting paroxysmal atrial fibrillation (AF) in acute ischemic stroke is difficult.
• Identifying cardioembolic stroke etiology is crucial for appropriate management.
• Cardiac structural metrics from echocardiography may offer diagnostic value.

Purpose of the Study:

• To evaluate the diagnostic utility of cardiac structural metrics for cardioembolic stroke.
• To assess the predictive performance of echocardiographic measurements in identifying stroke etiology.

Main Methods:

• A single-center cohort study included 1357 patients with ischemic stroke.
• Transthoracic echocardiography was performed within 7 days of stroke onset.
• Key measurements included left atrial diameter (LAD), right atrial diameter (RAD), and interventricular septal thickness (IVSd).

Main Results:

• 101 patients (7.4%) had cardioembolic stroke.
• LAD, RAD, and IVSd were independently associated with cardioembolic stroke.
• LAD showed the highest discriminative ability (AUC 0.744), outperforming RAD and IVSd.

Conclusions:

• Left atrial diameter (LAD) is a significant predictor of cardioembolic stroke, irrespective of AF status.
• Cardiac structural metrics, especially LAD, can assist in etiologic subtyping of acute ischemic stroke.
• Echocardiographic findings provide valuable insights for stroke diagnosis and management.