Left Atrial Dynamics Is Altered in Young Adults With Cryptogenic Ischemic Stroke : A Case-Control Study Utilizing Advanced Echocardiography

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Pirinen , J , Järvinen , V , Martinez-Majander , N , Sinisalo , J , Pöyhönen , P & Putaala , J 2020 , ' Left Atrial Dynamics Is Altered in Young Adults With Cryptogenic Ischemic Stroke : A Case-Control Study Utilizing Advanced Echocardiography ' , Journal of the American Heart Association , vol. 9 , no. 7 , 014578 . https://doi.org/10.1161/JAHA.119.014578

Title: Left Atrial Dynamics Is Altered in Young Adults With Cryptogenic Ischemic Stroke : A Case-Control Study Utilizing Advanced Echocardiography
Author: Pirinen, Jani; Järvinen, Vesa; Martinez-Majander, Nicolas; Sinisalo, Juha; Pöyhönen, Pauli; Putaala, Jukka
Contributor: University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Neurocenter
University of Helsinki, University of Helsinki
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, HUS Neurocenter
Date: 2020-04-09
Language: eng
Number of pages: 13
Belongs to series: Journal of the American Heart Association
ISSN: 2047-9980
URI: http://hdl.handle.net/10138/315692
Abstract: BACKGROUND: Ischemic stroke in young individuals often remains cryptogenic. Some of these strokes likely originate from the heart, and atrial fibrosis might be one of the etiological mechanisms. In this pilot study, we investigated whether advanced echocardiography findings of the left atrium (LA) of young cryptogenic stroke patients differ from those of stroke--free controls. METHODS AND RESULTS: We recruited 30 cryptogenic ischemic stroke patients aged 18 to 49 years and 30 age--and sex-matched stroke--free controls among participants of the SECRETO (Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome) study (NCT01934725). We measured basic left ventricular parameters and detailed measures of the LA, including 4--dimensional volumetry, speckle tracking epsilon, strain rate, and LA appendix orifice variation. Data were compared as continuous parameters and by tertiles. Compared with controls, stroke patients had smaller LA reservoir volumes (10.2 [interquartile range, 5.4] versus 13.2 [5.4] mL; P= 0.030) and smaller positive epsilon values (17.8 [8.5] versus 20.8 [10.1]; P= 0.023). In the tertile analysis, stroke patients had significantly lower left atrial appendage orifice variation (3.88 [0.75] versus 4.35 [0.90] mm; P=0.043), lower LA cyclic volume change (9.2 [2.8] versus 12.8 [3.5] mL; P=0.023), and lower LA contraction peak strain rate (-1.8 [0.6] versus -2.3 [0.6]; P=0.021). We found no statistically significant differences in left ventricular measures. CONCLUSIONS: This preliminary comparison suggests altered LA dynamics in young patients with cryptogenic ischemic stroke, and thus that LA wall pathology might contribute to these strokes. Our results await confirmation in a larger sample.
Subject: brain infarction
case-control study
echocardiography
stroke
young
stroke in
EMBOLIC STROKE
UNDETERMINED SOURCE
FIBRILLATION
EXPLANATIONS
ASSOCIATION
APPENDAGE
TRIGGERS
VOLUME
TIME
3112 Neurosciences
3124 Neurology and psychiatry
3121 General medicine, internal medicine and other clinical medicine
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