Relation Between Left Atrial Enlargement and Stroke Subtypes in Acute Ischemic Stroke Patients.
10.7461/jcen.2013.15.3.131
- Author:
Hye Young SHIN
1
;
In Hye JEONG
;
Chang Ki KANG
;
Dong Jin SHIN
;
Hyeon Mi PARK
;
Kee Hyung PARK
;
Young Hee SUNG
;
Dong Hoon SHIN
;
Young NOH
;
Yeong Bae LEE
Author Information
1. Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea. lyb@gilhospital.com
- Publication Type:Original Article
- Keywords:
Left atrial enlargement;
Ischemic stroke;
Stroke subtype;
Echocardiography
- MeSH:
Atrial Fibrillation;
Brain;
Cerebral Infarction;
Echocardiography;
Glycosaminoglycans;
Heart Valve Diseases;
Humans;
Hypertension;
Magnetic Resonance Imaging;
Odds Ratio;
Prevalence;
Risk Factors;
Stroke
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2013;15(3):131-136
- CountryRepublic of Korea
- Language:English
-
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.
