J Cerebrovasc Endovasc Neurosurg.  2013 Sep;15(3):131-136. 10.7461/jcen.2013.15.3.131.

Relation Between Left Atrial Enlargement and Stroke Subtypes in Acute Ischemic Stroke Patients

• Shin HY
• Jeong IH
• Kang CK
• Shin DJ
• Park HM
• Park KH
• Sung YH
• Shin DH
• Noh Y
• Lee YB

• KMID: 1491429
• DOI: http://doi.org/10.7461/jcen.2013.15.3.131

Abstract

OBJECTIVE
Increased atrial size is frequently seen in ischemic stroke patients in clinical practice. There is controversy about whether left atrial enlargement (LAE) should be regarded as a risk factor for cerebral infarction. We investigated the association between indexed left atrial volume (LAVI) and conventional stroke risk factors as well as stroke subtypes in acute ischemic stroke patients.
METHODS
One hundred eighty two acute cerebral infarction patients were included in this study. Brain magnetic resonance imaging and transthoracic echocardiography were done for all patients within 30 days of diagnosis of acute cerebral infarction. Echocardiographic LAE was identified when LAVI was more than 27 mL/m2. Stroke subtypes were classified by the Trial of Org 10171 in acute stroke treatment classification.
RESULTS
There were significant differences between subjects with normal and increased LAVI in prevalence of stroke risk factors including atrial fibrillation (p = 0.001), hypertension (p = 0.000), valvular heart disease (p = 0.011) and previous stroke (p = 0.031). An increased LAVI was associated with cardioembolic subtype with an adjusted odds ratio was 6.749 (p = 0.002) compared with small vessel disease.
CONCLUSION
Increased LAVI was more prevalent in those who had cardiovascular risk factors, such as atrial fibrillation, hypertension, valvular heart disease and history of previous stroke. LAE influenced most patients in all subtypes of ischemic stroke but was most prevalent in the cardioembolic stroke subtype. Increased LAVI might be a risk factor of cerebral infarction, especially in patients with cardioembolic stroke subtype.

Keyword

Left atrial enlargement; Ischemic stroke; Stroke subtype; Echocardiography

MeSH Terms

Atrial Fibrillation
Brain
Cerebral Infarction
Echocardiography
Glycosaminoglycans
Heart Valve Diseases
Humans
Hypertension
Magnetic Resonance Imaging
Odds Ratio
Prevalence
Risk Factors
Stroke
Glycosaminoglycans

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