Association between electrocardiographic and echocardiographic atrial abnormalities and prognosis in cryptogenic stroke.
| Autor: | Gatti Pianca E; Cardiology Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil; Post-Graduate Program in Cardiology and Cardiovascular Sciences, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: epianca@gmail.com., da Rosa LGB; Cardiology Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil. Electronic address: lgbrosa@hcpa.edu.br., Barcellos PT; Post-Graduate Program in Cardiology and Cardiovascular Sciences, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Martins SCO; Neurology Division, Hospital de Clínicas de Porto Alegre, Brazil. Electronic address: scmartins@hcpa.edu.br., Foppa M; Cardiology Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil; Post-Graduate Program in Cardiology and Cardiovascular Sciences, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: mufoppa@hcpa.edu.br., Pimentel M; Cardiology Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil; Post-Graduate Program in Cardiology and Cardiovascular Sciences, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: mpimentel@hcpa.edu.br., Santos ABS; Cardiology Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil; Post-Graduate Program in Cardiology and Cardiovascular Sciences, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: abssantos@hcpa.edu.br. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2020 Sep; Vol. 29 (9), pp. 105066. Date of Electronic Publication: 2020 Jun 25. |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2020.105066 |
| Abstrakt: | Background and Purpose: The role of atrial fibrillation in cryptogenic stroke (CS) is well known. However, the usefulness of left atrial (LA) electrical and morphological abnormalities to identify more disabling strokes in sinus rhythm patients is less studied. We evaluated the association between electrocardiographic P-wave abnormalities and echocardiographic LA measures with neurological disability in patients with cryptogenic stroke. Methods: In a retrospective cohort, we included all consecutive hospitalized patients with cryptogenic stroke. Patients were classified according to modified Rankin scale at hospital discharge and at 3 months. LA abnormalities were identified by electrocardiographic (ECG) P-wave, axis and LA enlargement criteria, and by bidimensional echocardiograph through left atrial diameter and volume index. Results: Among the 143 patients with CS (63.4 ± 14.2 years, 53% women), 70 patients were classified as non-disabling stroke (Rankin score < 2) and 73 patients as disabling stroke (Rankin score ≥ 2) at hospital discharge. On echocardiogram, more patients with disabling stroke presented with enlarged LA volume index (48% vs. 25%; p = 0.01). This difference remained significant after adjustment for age, gender, CHA Conclusion: Our study demonstrated an association between left atrial enlargement, assessed by downward deflection from ECG and volume index from echocardiogram, and more disabling cryptogenic strokes. This information could help to identify patients with poorer prognosis, or a subgroup where atrial cardiopathy may play a role in cardioembolic pathway. Competing Interests: Declaration of Competing Interest None declared. (Copyright © 2020 Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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