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. 2023 Apr;39(4):737-746.
doi: 10.1007/s10554-022-02779-6. Epub 2022 Dec 21.

Atrial cardiopathy in young adults with embolic stroke of undetermined source: a myocardial deformation imaging analysis

Carla Marques Pires  1 , Rita Silva  2 , Bárbara Lage Garcia  3 , Nuno Antunes  1 , Catarina Vieira  1 , Jorge Marques  1 , Sandro Queirós  3 , Vitor Hugo Pereira  4   5
Affiliations

Atrial cardiopathy in young adults with embolic stroke of undetermined source: a myocardial deformation imaging analysis

Carla Marques Pires et al. Int J Cardiovasc Imaging. 2023 Apr.

Abstract

Background: Atrial cardiopathy (AC) has emerged as a potential pathological thrombogenic atrial substract of embolic stroke of undetermined source (ESUS), even in the absence of atrial fibrillation. Left atrium (LA) myocardial deformation analysis may be of value as a subclinical marker of AC and a predictor of ESUS.

Aims: To compare LA mechanical function between ESUS cases and age and sex-matched controls.

Methods: A single-center analytical study with case-control design was performed. Case group was composed by young patients admitted in the Neurology department from January 2017 to June 2021. Control group was composed by age and sex matched controls recruited from the community. All participants performed echocardiogram and a smaller sample underwent cardiac magnetic resonance.

Results: We recruited 31 ESUS patients aged between 18 and 65 years and 31 age and sex matched controls. ESUS patients had a significantly higher prevalence of cardiovascular risk factors and patent foramen ovale (PFO). The prevalence of AC was not different between groups. Echocardiogram parameters, including strain analysis, were similar between groups, except for LA appendage (LAA) ostium variation which was significantly lower in ESUS patients (absolute: 6.5vs8.7mm, p<0.001; relative: 44.5%vs53.4%, p=0.002). After exclusion of patients with PFO, all the results were statistically similar. Regarding cardiac magnetic resonance analysis, there were no statistically significant differences between groups.

Conclusion: This study shows that in our population atria cardiopathy and atrial function was not associated with ESUS.LAA structural and functional abnormalities may play a major role. The role of LAA in ESUS warrants further studies.

Keywords: Atrial cardiopathy; Embolic stroke of undetermined source; Left atrium; Left atrium appendage; Myocardial deformation.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Atrial segmentation for longitudinal strain quantification using 2D echocardiography
See this image and copyright information in PMC

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