Sistema de Salut de Catalunya
Institut Català de la Salut
[Ble M] Medicine Department, Universidad Autónoma de Barcelona, 08035 Barcelona, Spain. Cardiology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain. [Benito B] Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain. Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Cuadrado-Godia E] Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain. Neurology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain. [Pérez-Fernández S] Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain. CIBER of Cardiovascular Diseases (CIBERCV), 08003 Barcelona, Spain. [Gómez M] Cardiology Department, Hospital de Barcelona, 08034 Barcelona, Spain. [Mas-Stachurska A] Cardiology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain. Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2022-04-25T15:03:09Z
2022-04-25T15:03:09Z
2021-08
Enfermedad auricular; Fibrilación auricular; Ecocardiografía
Malaltia auricular; Fibril·lació auricular; Ecocardiografia
Atrial disease; Atrial fibrillation; Echocardiography
Silent atrial fibrillation (AF) may be the cause of some cryptogenic strokes (CrS). The aim of the study was to analyse atrial size and function by speckle tracking echocardiography in CrS patients to detect atrial disease. Patients admitted to the hospital due to CrS were included prospectively. Echocardiogram analysis included left atrial ejection fraction (LAEF) and atrial strain. Insertable cardiac monitor was implanted, and AF was defined as an episode of ≥1 min in the first year after stroke. Left atrial enlargement was defined as indexed volume > 34 mL/m2. Seventy-five consecutive patients were included, aged 76 ± 9 years (arterial hypertension 75%). AF was diagnosed in 49% of cases. The AF group had higher atrial volume and worse atrial function: peak atrial longitudinal strain (PALs) 19.6 ± 5.7% vs. 29.5 ± 7.2%, peak atrial contraction strain (PACs) 8.9 ± 3.9% vs. 16.5 ± 6%, LAEF 46.8 ± 11.5% vs. 60.6 ± 5.2%; p < 0.001. AF was diagnosed in 20 of 53 patients with non-enlarged atrium, and in 18 of them, atrial dysfunction was present. The multivariate logistic regression analysis demonstrated an independent association between detection of AF and atrial volume, LAEF, and strain. Cut-off values were obtained: LAEF < 55%, PALs < 21.4%, and PACs < 12.9%. In conclusion, speckle tracking echocardiography in CrS patients improves silent atrial disease diagnosis, with or without atrial enlargement.
This research was funded by Instituto de Salud Carlos III-FIS (Fondo de Investigación Sanitaria, PI13/01830).
Article
Published version
English
Malalties cerebrovasculars; Fibril·lació auricular - Diagnòstic; Ecocardiografia; DISEASES::Cardiovascular Diseases::Vascular Diseases::Cerebrovascular Disorders::Brain Ischemia; DISEASES::Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac::Atrial Fibrillation; Other subheadings::Other subheadings::/diagnosis; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Cardiac Imaging Techniques::Echocardiography; ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::trastornos cerebrovasculares::isquemia cerebral; ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas::fibrilación atrial; Otros calificadores::Otros calificadores::/diagnóstico; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::técnicas de imagen cardíaca::ecocardiografía
MDPI
Journal of Clinical Medicine;10(16)
https://doi.org/10.3390/jcm10163501
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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