Original ArticleLeft Atrial Volume in the Prediction of First Ischemic Stroke in an Elderly Cohort Without Atrial Fibrillation
Section snippets
PATIENTS AND METHODS
After obtaining approval from the Mayo Foundation Institutional Review Board for this retrospective cohort study, we identified potential subjects from a computerized search of the echocardiography database and excluded patients who had not authorized use of their records (N=159). Search criteria included residence in Olmsted County, Minnesota, a record of undergoing transthoracic echocardiography at least once at the Mayo Clinic, Olmsted Medical Center, or their affiliated hospitals between
Predictors of First Ischemic Stroke
A total of 1554 residents in Olmsted County fulfilled all study criteria (920 women, 634 men). The mean ± SD age was 75+7 years (range, 65-100 years), and 92 residents (6%) had experienced 1 or more ischemic strokes over a mean ± SD follow-up period of 4.3+2.7 years. The incident stroke rate was 1.4 per 100 person-years.
The clinical, electrocardiographic, and echocardiographic characteristics of the cohort are shown in Table 1. Echocardiographic referral indications for these patients included
Prediction of First Ischemic Stroke: Clinical Implications of LA Size
The 3 principal findings of our study were as follows: (1) indexed LA volume contributes significantly and independently to the prediction of first ischemic stroke in elderly patients with no history of AF at baseline; (2) important differences exist between the use of conventional M-mode LA dimension and 2-dimensional biplane-indexed LA volume for ischemic stroke prediction, with indexed LA volume being more sensitive to change in stroke risk across the spectrum of LA size; and (3) enlarged LA
CONCLUSIONS
Echocardiographic assessment of LA volume provides a simple and quantitative assessment of risk for first ischemic stroke, independent of and incremental to clinical stroke risk factors. It is also an independent predictor of death.
REFERENCES (17)
History of the Rochester Epidemiology Project
Mayo Clin Proc
(1996)- et al.
Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women
J Am Coll Cardiol
(2002) - et al.
Two-dimensional echocardiographic determination of left atrial emptying volume: a noninvasive index in quantifying the degree of nonrheumatic mitral regurgitation
J Am Coll Cardiol
(1983) - et al.
Best method in clinical practice and in research studies to determine left atrial size
Am J Cardiol
(1999) - et al.
Asymmetric left atrial enlargement: an echocardiographic observation
Chest
(1976) - et al.
Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women
Mayo Clin Proc
(2001) - et al.
Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden
Am J Cardiol
(2002) Heart Disease and Stroke Statistics—2004 Update
(2003)
Cited by (257)
Atrial Cardiopathy: Redefining Stroke Risk Beyond Atrial Fibrillation
2023, American Journal of CardiologyLeft atrial overload detection in ECG using frequency domain features with machine learning and deep learning algorithms
2023, Biomedical Signal Processing and ControlLeft Atrial Deformation in Heart Failure: A Clinical Update
2023, Current Problems in CardiologyQuantification of Right Atrial-Indexed End-Systolic Volumes and Emptying Fraction in Children Undergoing Cardiac Surgery With Two-Dimensional Transesophageal Echocardiography: A Prospective Observational Study
2022, Journal of Cardiothoracic and Vascular AnesthesiaSignal-to-noise of linear and volume measures of left ventricular and left atrial size
2024, Cardiovascular Ultrasound
This study was supported by a grant from the American Society of Echocardiography.