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Incremental Value of Left Atrial Global Longitudinal Strain for Prediction of Post Stroke Atrial Fibrillation in Patients with Acute Ischemic Stroke

BACKGROUND: Atrial fibrillation (AF) is a well-established risk factor for stroke. Interestingly, ischemic stroke increases risk of incident AF in patients without prior diagnosed AF. For better risk stratification for post-stroke AF, we studied left atrial (LA) size and mechanical function using tw...

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Autores principales: Kim, Darae, Shim, Chi Young, Cho, In Jeong, Kim, Young Dae, Nam, Hyo Suk, Chang, Hyuk-Jae, Hong, Geu-Ru, Ha, Jong-Won, Heo, Ji Hoe, Chung, Namsik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Echocardiography 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828410/
https://www.ncbi.nlm.nih.gov/pubmed/27081440
http://dx.doi.org/10.4250/jcu.2016.24.1.20
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author Kim, Darae
Shim, Chi Young
Cho, In Jeong
Kim, Young Dae
Nam, Hyo Suk
Chang, Hyuk-Jae
Hong, Geu-Ru
Ha, Jong-Won
Heo, Ji Hoe
Chung, Namsik
author_facet Kim, Darae
Shim, Chi Young
Cho, In Jeong
Kim, Young Dae
Nam, Hyo Suk
Chang, Hyuk-Jae
Hong, Geu-Ru
Ha, Jong-Won
Heo, Ji Hoe
Chung, Namsik
author_sort Kim, Darae
collection PubMed
description BACKGROUND: Atrial fibrillation (AF) is a well-established risk factor for stroke. Interestingly, ischemic stroke increases risk of incident AF in patients without prior diagnosed AF. For better risk stratification for post-stroke AF, we studied left atrial (LA) size and mechanical function using two-dimensional (2D) speckle tracking imaging in patients with acute ischemic stroke. METHODS: A total of 227 patients (132 males, age 67 ± 12) with acute ischemic stroke without a history of AF underwent 2D transthoracic echocardiography and speckle tracking imaging for the assessment of LA volume index and global LA longitudinal strain (LALS). From clinical variables, the CHA(2)DS(2)-VASc score and National Institute of Health Stroke Scale (NIHSS) were calculated in each patient. Post-stroke AF was defined as newly diagnosed AF during the course after ischemic stroke. RESULTS: Post-stroke AF occurred in 25 patients (11%). Patients with post-stroke AF were older and showed a higher tendency of CHA(2)DS(2)-VASc score, significantly higher log NIHSS, larger LA volume index and lower global LALS than those without. In multivariate analysis, global LALS was an independent predictor for post-stroke AF (hazard ratio 0.90, 95% confidence interval 0.83.0.97, p < 0.01) after controlling for confounding factors. Furthermore, global LALS provided incremental predictive value for post-stroke AF over the CHA(2)DS(2)-VASc score, NIHSS, and LA volume index. The global LALS < 14.5% better distinguished post-stroke AF (area under the curve 0.837, sensitivity 60%, specificity 95%, p < 0.01) than CHA(2)DS(2)-VASc score. CONCLUSION: Global LALS as a marker of LA mechanical function has incremental predictive value for post-stroke AF in patients with acute ischemic stroke.
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spelling pubmed-48284102016-04-14 Incremental Value of Left Atrial Global Longitudinal Strain for Prediction of Post Stroke Atrial Fibrillation in Patients with Acute Ischemic Stroke Kim, Darae Shim, Chi Young Cho, In Jeong Kim, Young Dae Nam, Hyo Suk Chang, Hyuk-Jae Hong, Geu-Ru Ha, Jong-Won Heo, Ji Hoe Chung, Namsik J Cardiovasc Ultrasound Original Article BACKGROUND: Atrial fibrillation (AF) is a well-established risk factor for stroke. Interestingly, ischemic stroke increases risk of incident AF in patients without prior diagnosed AF. For better risk stratification for post-stroke AF, we studied left atrial (LA) size and mechanical function using two-dimensional (2D) speckle tracking imaging in patients with acute ischemic stroke. METHODS: A total of 227 patients (132 males, age 67 ± 12) with acute ischemic stroke without a history of AF underwent 2D transthoracic echocardiography and speckle tracking imaging for the assessment of LA volume index and global LA longitudinal strain (LALS). From clinical variables, the CHA(2)DS(2)-VASc score and National Institute of Health Stroke Scale (NIHSS) were calculated in each patient. Post-stroke AF was defined as newly diagnosed AF during the course after ischemic stroke. RESULTS: Post-stroke AF occurred in 25 patients (11%). Patients with post-stroke AF were older and showed a higher tendency of CHA(2)DS(2)-VASc score, significantly higher log NIHSS, larger LA volume index and lower global LALS than those without. In multivariate analysis, global LALS was an independent predictor for post-stroke AF (hazard ratio 0.90, 95% confidence interval 0.83.0.97, p < 0.01) after controlling for confounding factors. Furthermore, global LALS provided incremental predictive value for post-stroke AF over the CHA(2)DS(2)-VASc score, NIHSS, and LA volume index. The global LALS < 14.5% better distinguished post-stroke AF (area under the curve 0.837, sensitivity 60%, specificity 95%, p < 0.01) than CHA(2)DS(2)-VASc score. CONCLUSION: Global LALS as a marker of LA mechanical function has incremental predictive value for post-stroke AF in patients with acute ischemic stroke. Korean Society of Echocardiography 2016-03 2016-03-24 /pmc/articles/PMC4828410/ /pubmed/27081440 http://dx.doi.org/10.4250/jcu.2016.24.1.20 Text en Copyright © 2016 Korean Society of Echocardiography http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Darae
Shim, Chi Young
Cho, In Jeong
Kim, Young Dae
Nam, Hyo Suk
Chang, Hyuk-Jae
Hong, Geu-Ru
Ha, Jong-Won
Heo, Ji Hoe
Chung, Namsik
Incremental Value of Left Atrial Global Longitudinal Strain for Prediction of Post Stroke Atrial Fibrillation in Patients with Acute Ischemic Stroke
title Incremental Value of Left Atrial Global Longitudinal Strain for Prediction of Post Stroke Atrial Fibrillation in Patients with Acute Ischemic Stroke
title_full Incremental Value of Left Atrial Global Longitudinal Strain for Prediction of Post Stroke Atrial Fibrillation in Patients with Acute Ischemic Stroke
title_fullStr Incremental Value of Left Atrial Global Longitudinal Strain for Prediction of Post Stroke Atrial Fibrillation in Patients with Acute Ischemic Stroke
title_full_unstemmed Incremental Value of Left Atrial Global Longitudinal Strain for Prediction of Post Stroke Atrial Fibrillation in Patients with Acute Ischemic Stroke
title_short Incremental Value of Left Atrial Global Longitudinal Strain for Prediction of Post Stroke Atrial Fibrillation in Patients with Acute Ischemic Stroke
title_sort incremental value of left atrial global longitudinal strain for prediction of post stroke atrial fibrillation in patients with acute ischemic stroke
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828410/
https://www.ncbi.nlm.nih.gov/pubmed/27081440
http://dx.doi.org/10.4250/jcu.2016.24.1.20
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