Abstract WMP65: Left Atrial Enlargement Without Atrial Fibrillation: A Risk Factor for Ischemic Stroke?

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Omar Saeed ◽  
Muhammad A Saleem ◽  
Shawn S Wallery ◽  
Adnan I Qureshi
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Left Atrial ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement

Abstract 12799: Left Atrial Enlargement is an Independent Risk Factor of Stroke or Systemic Embolism in Atrial Fibrillation Patients: The Fushimi AF Registry

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yasuhiro Hamatani ◽  
Daisuke Takagi ◽  
Hisashi Ogawa ◽  
Masahiro Esato ◽  
Yeong-Hwa Chun ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Left Atrial ◽  
Systemic Embolism ◽  
Left Atrial Diameter ◽  
Left Atrial Enlargement ◽  
Valvular Heart Diseases ◽  
Increased Risk ◽  
Atrial Enlargement

Introduction: Atrial fibrillation (AF) is a common arrhythmic disorder and increasing significantly. Stroke or systemic embolism (SE) is a devastating complication of AF. Controversy exists regarding whether left atrial enlargement is a risk factor of stroke/SE in AF patients. Hypothesis: Left atrial enlargement might be associated with the incidence of stroke/SE. Methods: The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, which represented a typical urban community in Japan. We started to enroll patients from March 2011, and follow-up data were available for 2,724 patients by April 2015 (median follow-up period 808 days). Left atrial enlargement (LAE) was diagnosed if the left atrial diameter measured by transthoracic echocardiography was >45 mm. We compared the backgrounds and incidences of events during follow-up period between those with LAE and those without it (non-LAE). Results: Backgrounds and incidences of events between LAE and non-LAE are shown in the Table. LAE group showed higher incidence of stroke/SE during follow-up period, compared with non-LAE group (hazard ratio (HR): 1.81, 95% confidence interval (CI): 1.29-2.57, p<0.01). After adjustment by the components of CHADS2 score and oral anticoagulant prescription, LAE was independently associated with higher risk for stroke/SE (HR: 1.70, 95% CI: 1.20-2.43, p<0.01). This was also the case when we defined cut-off as 40 mm (HR: 1.67, 95% CI: 1.12-2.55, p=0.01), and as 50 mm (HR: 1.58, 95% CI: 1.08-2.29, p=0.02), or we analyzed left atrial diameter as continuous variables (HR (per 1mm): 1.03, 95% CI: 1.01-1.05, p<0.01). Even after adjustment by type of AF (paroxysmal or sustained) and valvular heart diseases, LAE remained to be independently associated with the risk of stroke/SE (HR: 1.57, 95% CI: 1.08-2.31, p=0.02). Conclusion: Left atrial enlargement was independently associated with the increased risk of stroke/SE in AF patients.

scholarly journals Serum D-dimer Levels Are Proportionally Associated with Left Atrial Enlargement in Patients with an Acute Ischemic Stroke due to Non-valvular Atrial Fibrillation

2016 ◽  
Vol 55 (11) ◽  
pp. 1447-1452 ◽  
Author(s):  
Tae-Won Kim ◽  
In-Uk Song ◽  
Sung-Woo Chung ◽  
Joong-Seok Kim ◽  
Jaseong Koo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrial ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement ◽  
D Dimer

P3755Left atrial enlargement as an independent risk factor for ischemic stroke in Japanese atrial fibrillation patients: pooled analysis of five major Japanese atrial fibrillation registries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Akao ◽  
H Ogawa ◽  
S Suzuki ◽  
T Yamashita ◽  
E Kodani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Oral Anticoagulant ◽  
Left Atrial ◽  
Large Scale ◽  
Chads2 Score ◽  
Left Atrial Diameter ◽  
Atrial Enlargement ◽  
The Impact

Abstract Background Atrial fibrillation (AF) increases the risk of ischemic stroke. It remains unknown whether left atrial diameter determined by routine trans-thoracic echocardiography is a risk factor for ischemic stroke in non-valvular AF (NVAF) patients. Purpose The aim of this study is to investigate the impact of left atrial enlargement (LAE) on the incidence of ischemic stroke in a large-scale cohort of Japanese NVAF patients. Methods We combined the data of 5 major AF registries in Japan, J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and Hokuriku AF Registry. After excluding patients without echocardiographic data, 7,672 NVAF patients were analyzed in the present study (mean age, 69.3±12.3 years; mean CHADS2 score, 1.6±1.3). We compared clinical characteristics and the incidence of ischemic stroke between NVAF patients with LAE (left atrial diameter >45 mm; LAE group) and those without (non-LAE group). Results The mean left atrial diameter was 43.1±8.6 mm, and the LAE group accounted for 40.0% (n=3,066) of the entire cohort. Compared with non-LAE group (60.0%, n=4,606), the LAE group was older (LAE vs. non-LAE; 70.3±12.0 vs. 68.0±12.5, p<0.01), more often non-paroxysmal type (73.7% vs. 32.1%, p<0.01), had higher CHADS2 (1.86±1.34 vs. 1.46±1.29, p<0.01) and CHA2DS2-VASc (3.02±1.83 vs. 2.53±1.78, p<0.01) scores, and more frequently received oral anticoagulant (72.9% vs. 55.0%, p<0.01). During the median follow-up period of 774.5 days (interquartile range: 567–1466 days), ischemic stroke occurred in 241 patients (131 vs. 110 patients; 1.52 vs. 0.82 per 100 person-years). In Kaplan Meier analysis, LAE was associated with a higher incidence of ischemic stroke (unadjusted hazard ratio (HR): 1.83, 95% confidence interval (CI): 1.42–2.36; log rank p<0.01) (Figure). LAE was independently associated with increased risk of ischemic stroke (adjusted HR: 1.63, 95% CI: 1.25–2.11; p<0.01) after adjustment by the components of CHADS2 score and the use of oral anticoagulant, on multivariate Cox proportional hazard analysis. Conclusion In this large-scale cohort of Japanese patients with AF, LAE was an independent predictor of ischemic stroke, suggesting that this simple echocardiographic parameter could refine thromboembolic risk stratification of NVAF patients. Acknowledgement/Funding Japan Agency for Medical Research and Development, AMED

Left Atrial Enlargement and Anticoagulation Status in Patients with Acute Ischemic Stroke and Atrial Fibrillation

2018 ◽  
Vol 27 (1) ◽  
pp. 192-197 ◽  
Author(s):  
Katarina Dakay ◽  
Andrew D. Chang ◽  
Morgan Hemendinger ◽  
Shawna Cutting ◽  
Ryan A. McTaggart ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrial ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement

scholarly journals Association between Left Atrial Enlargement on Echocardiography and In-hospital Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke

2015 ◽  
Vol 21 (2) ◽  
pp. 82-86
Author(s):  
Kyung Bok Lee ◽  
Ji-Sun Kim ◽  
Hakjae Roh ◽  
Moo-Young Ahn ◽  
Byoung Won Park ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrial ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement

Abstract TMP112: Left Atrial Enlargement is Associated With Anticoagulation Failure in Patients With Acute Ischemic Stroke and Atrial Fibrillation

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Katarina Dakay ◽  
Andrew D Chang ◽  
Morgan Hemendinger ◽  
Shawna M Cutting ◽  
Ryan A McTaggart ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrial ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement

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

2013 ◽  
Vol 15 (3) ◽  
pp. 131 ◽  
Author(s):  
Hye-Young Shin ◽  
In-Hye Jeong ◽  
Chang-Ki Kang ◽  
Dong-Jin Shin ◽  
Hyeon-Mi Park ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrial ◽  
Stroke Patients ◽  
Left Atrial Enlargement ◽  
Stroke Subtypes ◽  
Atrial Enlargement

scholarly journals The clinical and etiological profile of atrial fibrillation after echocardiography in a tertiary care centre from North India - a cross sectional observational study

2017 ◽  
Vol 5 (3) ◽  
pp. 847 ◽  
Author(s):  
Ranvijay Singh ◽  
Rajesh Kashyap ◽  
Rajeev Bhardwaj ◽  
Rajeev Marwaha ◽  
Manish Thakur ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Tertiary Care ◽  
Hypertensive Heart Disease ◽  
Atrial Appendage ◽  
North India ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. In western countries, rheumatic heart disease (RHD) is a rare cause of atrial fibrillation but in developing countries like India it is one of the commonest cause of atrial fibrillation. We studied etiology, left atrial size and the incidence of left atrial appendage clot in patients with atrial fibrillation at our institution so that guidelines could be formulated to manage the patients of AF in the hours of emergency.Methods: 110 consecutive patients of atrial fibrillation coming to emergency, cardiology and medicine outpatient department over a period of one year were enrolled for the study. Ethical committee clearance was taken. Detailed history were taken, clinical presentation reviewed  and examination were carried out. All patients were subjected to transthoracic echocardiography and for transesophageal echocardiography if required.Results: The mean age of patients in the study was 58.42±14.27 years (range 22-90 years). Maximum numbers of patients were in the age group of 61-70 years (26.37%). Out of 110 patients with atrial fibrillation, 72 patients (65.46%) were females and 38 patients (34.54%) were males. Majority of patients presented with more than one symptom. Out of 110, 66 patients (60%) had RHD. Among RHD patients, 50 patients (45.55%) were females and 16 patients (14.55%) were males. Next common causes were hypertensive heart disease and degenerative valvular heart disease.Conclusions: In our study RHD was the most common cause of atrial fibrillation, followed by hypertensive heart disease and degenerative valvular heart disease. Mitral valve involvement was seen in all patients of RHD. Left atrial enlargement was seen in majority of patients, so left atrial enlargement could be a predictor of atrial fibrillation. Patients of left atrial enlargement are more prone to develop left atrial appendage clot.

Abstract WP272: Left Atrial Enlargement is Associated With Neuroworsening and Worse Short-Term Outcomes in Acute Ischemic Stroke

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Alyana A Samai ◽  
Karen Albright ◽  
Digvijaya Navalkele ◽  
Carmel Alemayehu ◽  
Sheryl Martin-Schild
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrial ◽  
Short Term ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement
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