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Left atrial shape as a marker of atrial myopathy in embolic stroke of undetermined source.
Ferkh, Aaisha; De Silva, Kasun; Pham, Jennifer; Stefani, Luke; Byth, Karen; Clark, Amy; Trivedi, Siddharth J; Nagaratnam, Sai; Duggins, Andrew; Kizana, Eddy; Thiagalingam, Aravinda; Thomas, Liza.
Afiliación
  • Ferkh A; Westmead Clinical School, University of Sydney, Darcy Road, Westmead, NSW 2145, Australia.
  • De Silva K; Cardiology Department, Westmead Hospital, Corner Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia.
  • Pham J; Westmead Clinical School, University of Sydney, Darcy Road, Westmead, NSW 2145, Australia.
  • Stefani L; Cardiology Department, Westmead Hospital, Corner Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia.
  • Byth K; Cardiology Department, Westmead Hospital, Corner Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia.
  • Clark A; Westmead Clinical School, University of Sydney, Darcy Road, Westmead, NSW 2145, Australia.
  • Trivedi SJ; Cardiology Department, Westmead Hospital, Corner Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia.
  • Nagaratnam S; WSLHD Research and Education Network, Westmead Hospital, Westmead, NSW, Australia.
  • Duggins A; Westmead Clinical School, University of Sydney, Darcy Road, Westmead, NSW 2145, Australia.
  • Kizana E; Cardiology Department, Westmead Hospital, Corner Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia.
  • Thiagalingam A; Westmead Clinical School, University of Sydney, Darcy Road, Westmead, NSW 2145, Australia.
  • Thomas L; Cardiology Department, Westmead Hospital, Corner Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia.
Eur Heart J Cardiovasc Imaging ; 25(8): 1155-1163, 2024 Jul 31.
Article en En | MEDLINE | ID: mdl-38487870
ABSTRACT

AIMS:

Embolic stroke of undetermined source (ESUS) results in significant morbidity. A left atrial (LA) myopathy is implicated in a proportion of these patients. We hypothesized that LA shape varies by cause of stroke [CE (cardioembolic) vs. ESUS]. METHODS AND

RESULTS:

A total of 236 ischaemic stroke and atrial fibrillation (AF) patients and controls were recruited prospectively. AF was classified as paroxysmal AF (PAF) or persistent AF (PersAF). Stroke patients comprised CE stroke secondary to AF and ESUS. There were 81 AF (47 PAF, 34 PersAF), 50 ESUS, 57 CE patients [subdivided into CE with PAF (CEpaf) and CE with PersAF (CEpers)], and 48 controls. Echocardiographic parameters including LA volume, function, and shape/sphericity (3D LA sphericity and 2D-derived LA circularity, ellipticity, sphericity, and eccentricity indices) were evaluated. Increased LA volume and sphericity with LA dysfunction were present in CE, AF, and ESUS groups compared with controls. K-means cluster analysis demonstrated a spectrum of LA myopathy with controls at the lowest and CEpers and PersAF at the upper extremes, with ESUS, PAF, and CEpaf being similar and falling between these extremes. After adjusting for age, sex, and left ventricular (LV) and LA parameters, LA sphericity markers differentiated ESUS from controls (P < 0.01).

CONCLUSION:

Alterations in LA shape are present in ESUS, AF, and CE patients, particularly increased spherical remodelling. The novel markers of LA sphericity proposed may identify LA myopathy in ESUS patients and potentially guide management for secondary prevention.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Accidente Cerebrovascular Embólico / Atrios Cardíacos Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Heart J Cardiovasc Imaging Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Accidente Cerebrovascular Embólico / Atrios Cardíacos Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Heart J Cardiovasc Imaging Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido