Left Atrial Dysfunction and Deformation as Predictors of Recurrent Stroke in Patients with Atrial Fibrillation and First Acute Ischemic Stroke

Abstract

Background: Although further research is necessary before adding LA strain to the present risk scheme, it may be a useful marker for stratifying stroke risk. Novel deformation imaging is becoming a widely used method for AF risk categorization at the moment. LA strain is the most widely utilised index for risk stratification among all LA deformation parameters, particularly for the course of AF. There aren't many investigations on the connection between AF-related stroke and LA distortion.

Aim: Toevaluate is relation between Left atrium deformation and dysfunction in AF patient and recurrent stroke.

Materials and methods: This observational case control study was conducted at emergency room (ER), cardiac care units (CCU), ward and Echo cardiograph units of cardiology department, Zagazig university hospitals. This study included 92 patients with acute ischemic stroke. Left atrial function and deformation were assessed.

 Results: there was statistically significant difference between both subgroups with higher CHADSVASC score in the subgroup who developed recurrent stroke. There was statistically significant difference between both groups regarding all these parameters with better left ventricular and left atrial parameters in the subgroup who did not develop recurrent stroke. Conclusion: In conclusion, Patients with larger LA dimensions and impaired LA function assessed by strain and strain rate are more liable for recurrent stroke than those with normal dimensions and function. LA strain and strain rate outperformed the CHA2DS2-VASc score in predicting ischemic stroke in a broader and greater clinical risk cohort, independent of important AF baseline demographics and conventional echocardiography measures. LA strains could be used as possible risk stratification markers.