Skip to main content
Erschienen in:

06.02.2024 | Original Article

Left atrial strain time integral evaluated by two-dimensional speckle tracking predicts left atrial appendage dysfunction in patients with acute ischemic stroke

verfasst von: Aoi Takahata, Tetsu Watanabe, Masahiro Wanezaki, Takayuki Nagai, Shunsuke Edamura, Hayato Tsuchiya, Harutoshi Tamura, Satoshi Nishiyama, Yoichiro Otaki, Daisuke Kutsuzawa, Shigehiko Kato, Takanori Arimoto, Hiroki Takahashi, Masafumi Watanabe

Erschienen in: Heart and Vessels | Ausgabe 5/2024

Einloggen, um Zugang zu erhalten

Abstract

Cardioembolic stroke is a serious disease with poor prognosis, whose main embolic source is the left atrial appendage (LAA). Left atrial (LA) strain evaluated by the two-dimensional (2D) speckle tracking technique has been proposed. However, the commonly used peak LA strain reflects only LA reservoir function. The LA strain also includes indicators of the other LA functions, such as booster pump function, which reflects active contraction of the LA. This study aimed to investigate whether a newly developed parameter, the left atrial strain time integral (LASTI), can evaluate LAA dysfunction more accurately in patients with acute stroke. We measured LA strain using a 2D speckle tracking method in 168 patients with acute stroke and 20 age-matched control subjects. LASTI was calculated as the area under the LA strain curve in one cardiac cycle. LAA dysfunction was defined as LAA thrombus and/or severe spontaneous echo contrast by transesophageal echocardiography. LASTI was significantly lower in patients with LAA dysfunction than those without. LASTI was a better correlation with LAA blood flow velocity measured by transesophageal echocardiography than peak LA strain. Multivariate logistic regression analysis showed that LASTI was an independent predictor of LAA dysfunction after adjustment for conventional risk factors. LASTI can be a feasible parameter for predicting LAA dysfunction in patients with acute stroke.
Literatur
2.
Zurück zum Zitat Whisnant J, Basford J, Bernstein E, Cooper E, Dyken M, Easton J, Little J, Marler J, Millikan C, Petito C, Price T, Raichle M, Robertson JT, Thiele B, Walker M, Zimmerman R (1990) Special report from the National Institute of Neurological Disorders and Stroke Classification of cerebrovascular diseases III. Stroke 21(4):637–676CrossRef Whisnant J, Basford J, Bernstein E, Cooper E, Dyken M, Easton J, Little J, Marler J, Millikan C, Petito C, Price T, Raichle M, Robertson JT, Thiele B, Walker M, Zimmerman R (1990) Special report from the National Institute of Neurological Disorders and Stroke Classification of cerebrovascular diseases III. Stroke 21(4):637–676CrossRef
3.
Zurück zum Zitat Cooper R, Cutler J, Desvigne-Nickens P, Fortmann SP, Friedman L, Havlik R, Hogelin G, Marler J, McGovern P, Morosco G, Mosca L, Pearson T, Stamler J, Stryer D, Thom T (2000) Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention. Circulation 102(25):3137–3147CrossRefPubMed Cooper R, Cutler J, Desvigne-Nickens P, Fortmann SP, Friedman L, Havlik R, Hogelin G, Marler J, McGovern P, Morosco G, Mosca L, Pearson T, Stamler J, Stryer D, Thom T (2000) Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention. Circulation 102(25):3137–3147CrossRefPubMed
4.
Zurück zum Zitat Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D (1998) Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 98(10):946–952CrossRefPubMed Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D (1998) Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 98(10):946–952CrossRefPubMed
5.
Zurück zum Zitat Takada T, Yasaka M, Nagatsuka K, Minematsu K, Yamaguchi T (2001) Blood flow in the left atrial appendage and embolic stroke in nonvalvular atrial fibrillation. Eur Neurol 46(3):148–152CrossRefPubMed Takada T, Yasaka M, Nagatsuka K, Minematsu K, Yamaguchi T (2001) Blood flow in the left atrial appendage and embolic stroke in nonvalvular atrial fibrillation. Eur Neurol 46(3):148–152CrossRefPubMed
6.
Zurück zum Zitat Garcia-Fernandez MA, Torrecilla EG, San Roman D, Azevedo J, Bueno H, Moreno MM, Delcan JL (1992) Left atrial appendage Doppler flow patterns: implications on thrombus formation. Am Heart J 124(4):955–961CrossRefPubMed Garcia-Fernandez MA, Torrecilla EG, San Roman D, Azevedo J, Bueno H, Moreno MM, Delcan JL (1992) Left atrial appendage Doppler flow patterns: implications on thrombus formation. Am Heart J 124(4):955–961CrossRefPubMed
7.
Zurück zum Zitat Kamp O, Verhorst PM, Welling RC, Visser CA (1999) Importance of left atrial appendage flow as a predictor of thromboembolic events in patients with atrial fibrillation. Eur Heart J 20(13):979–985CrossRefPubMed Kamp O, Verhorst PM, Welling RC, Visser CA (1999) Importance of left atrial appendage flow as a predictor of thromboembolic events in patients with atrial fibrillation. Eur Heart J 20(13):979–985CrossRefPubMed
8.
Zurück zum Zitat Verhorst PM, Kamp O, Visser CA, Verheugt FW (1993) Left atrial appendage flow velocity assessment using transesophageal echocardiography in nonrheumatic atrial fibrillation and systemic embolism. Am J Cardiol 71(2):192–196CrossRefPubMed Verhorst PM, Kamp O, Visser CA, Verheugt FW (1993) Left atrial appendage flow velocity assessment using transesophageal echocardiography in nonrheumatic atrial fibrillation and systemic embolism. Am J Cardiol 71(2):192–196CrossRefPubMed
9.
Zurück zum Zitat Sun BJ, Park JH (2021) Echocardiographic measurement of left atrial strain—a key requirement in clinical practice. Circ J 86(1):6–13CrossRefPubMed Sun BJ, Park JH (2021) Echocardiographic measurement of left atrial strain—a key requirement in clinical practice. Circ J 86(1):6–13CrossRefPubMed
10.
Zurück zum Zitat Sasaki S, Watanabe T, Tamura H, Nishiyama S, Wanezaki M, Sato C, Yamaura G, Ishino M, Arimoto T, Takahashi H, Shishido T, Miyamoto T, Kubota I (2014) Left atrial strain as evaluated by two-dimensional speckle tracking predicts left atrial appendage dysfunction in patients with acute ischemic stroke. BBA Clin 2:40–47CrossRefPubMedPubMedCentral Sasaki S, Watanabe T, Tamura H, Nishiyama S, Wanezaki M, Sato C, Yamaura G, Ishino M, Arimoto T, Takahashi H, Shishido T, Miyamoto T, Kubota I (2014) Left atrial strain as evaluated by two-dimensional speckle tracking predicts left atrial appendage dysfunction in patients with acute ischemic stroke. BBA Clin 2:40–47CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Sachdeva S, Desai R, Andi K, Vyas A, Deliwala S, Sachdeva R, Kumar G (2021) Reduced left atrial strain can predict stroke in atrial fibrillation—a meta-analysis. Int J Cardiol Heart Vasc 36:100859PubMedPubMedCentral Sachdeva S, Desai R, Andi K, Vyas A, Deliwala S, Sachdeva R, Kumar G (2021) Reduced left atrial strain can predict stroke in atrial fibrillation—a meta-analysis. Int J Cardiol Heart Vasc 36:100859PubMedPubMedCentral
12.
Zurück zum Zitat Park JH, Hwang IC, Park JJ, Park JB, Cho GY (2021) Left Atrial Strain to Predict Stroke in Patients With Acute Heart Failure and Sinus Rhythm. J Am Heart Assoc 10(13):e020414CrossRefPubMedPubMedCentral Park JH, Hwang IC, Park JJ, Park JB, Cho GY (2021) Left Atrial Strain to Predict Stroke in Patients With Acute Heart Failure and Sinus Rhythm. J Am Heart Assoc 10(13):e020414CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Hirose T, Kawasaki M, Tanaka R, Ono K, Watanabe T, Iwama M, Noda T, Watanabe S, Takemura G, Minatoguchi S (2012) Left atrial function assessed by speckle tracking echocardiography as a predictor of new-onset non-valvular atrial fibrillation: results from a prospective study in 580 adults. Eur Heart J Cardiovasc Imaging 13(3):243–250CrossRefPubMed Hirose T, Kawasaki M, Tanaka R, Ono K, Watanabe T, Iwama M, Noda T, Watanabe S, Takemura G, Minatoguchi S (2012) Left atrial function assessed by speckle tracking echocardiography as a predictor of new-onset non-valvular atrial fibrillation: results from a prospective study in 580 adults. Eur Heart J Cardiovasc Imaging 13(3):243–250CrossRefPubMed
14.
Zurück zum Zitat Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ (2001) Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA 285(22):2864–2870CrossRefPubMed Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ (2001) Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA 285(22):2864–2870CrossRefPubMed
15.
Zurück zum Zitat Masaki N, Suzuki M, Iwatsuka R, Mizukami A, Kumasaka L, Nagahori W, Ohno M, Matsumura A, Maruyama Y, Hashimoto Y (2009) Effectiveness of risk stratification according to CHADS2 score in Japanese patients with nonvalvular atrial fibrillation. Int Heart J 50(3):323–329CrossRefPubMed Masaki N, Suzuki M, Iwatsuka R, Mizukami A, Kumasaka L, Nagahori W, Ohno M, Matsumura A, Maruyama Y, Hashimoto Y (2009) Effectiveness of risk stratification according to CHADS2 score in Japanese patients with nonvalvular atrial fibrillation. Int Heart J 50(3):323–329CrossRefPubMed
16.
Zurück zum Zitat Brott T, Marler JR, Olinger CP, Adams HP Jr, Tomsick T, Barsan WG, Biller J, Eberle R, Hertzberg V, Walker M (1989) Measurements of acute cerebral infarction: lesion size by computed tomography. Stroke 20(7):871–875CrossRefPubMed Brott T, Marler JR, Olinger CP, Adams HP Jr, Tomsick T, Barsan WG, Biller J, Eberle R, Hertzberg V, Walker M (1989) Measurements of acute cerebral infarction: lesion size by computed tomography. Stroke 20(7):871–875CrossRefPubMed
17.
Zurück zum Zitat Puwanant S, Varr BC, Shrestha K, Hussain SK, Tang WH, Gabriel RS, Wazni OM, Bhargava M, Saliba WI, Thomas JD, Lindsay BD, Klein AL (2009) Role of the CHADS2 score in the evaluation of thromboembolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation. J Am Coll Cardiol 54(22):2032–2039CrossRefPubMed Puwanant S, Varr BC, Shrestha K, Hussain SK, Tang WH, Gabriel RS, Wazni OM, Bhargava M, Saliba WI, Thomas JD, Lindsay BD, Klein AL (2009) Role of the CHADS2 score in the evaluation of thromboembolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation. J Am Coll Cardiol 54(22):2032–2039CrossRefPubMed
18.
Zurück zum Zitat Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ (2010) Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest 137(2):263–272CrossRefPubMed Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ (2010) Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest 137(2):263–272CrossRefPubMed
19.
Zurück zum Zitat Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1):1-39 e14CrossRefPubMed Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1):1-39 e14CrossRefPubMed
20.
Zurück zum Zitat Tamura H, Watanabe T, Hirono O, Nishiyama S, Sasaki S, Shishido T, Miyashita T, Miyamoto T, Nitobe J, Kayama T, Kubota I (2010) Low wall velocity of left atrial appendage measured by trans-thoracic echocardiography predicts thrombus formation caused by atrial appendage dysfunction. J Am Soc Echocardiogr 23(5):545-552 e541CrossRefPubMed Tamura H, Watanabe T, Hirono O, Nishiyama S, Sasaki S, Shishido T, Miyashita T, Miyamoto T, Nitobe J, Kayama T, Kubota I (2010) Low wall velocity of left atrial appendage measured by trans-thoracic echocardiography predicts thrombus formation caused by atrial appendage dysfunction. J Am Soc Echocardiogr 23(5):545-552 e541CrossRefPubMed
21.
Zurück zum Zitat Tamura H, Watanabe T, Nishiyama S, Sasaki S, Wanezaki M, Arimoto T, Takahashi H, Shishido T, Miyashita T, Miyamoto T, Kubota I (2012) Prognostic value of low left atrial appendage wall velocity in patients with ischemic stroke and atrial fibrillation. J Am Soc Echocardiogr 25(5):576–583CrossRefPubMed Tamura H, Watanabe T, Nishiyama S, Sasaki S, Wanezaki M, Arimoto T, Takahashi H, Shishido T, Miyashita T, Miyamoto T, Kubota I (2012) Prognostic value of low left atrial appendage wall velocity in patients with ischemic stroke and atrial fibrillation. J Am Soc Echocardiogr 25(5):576–583CrossRefPubMed
22.
Zurück zum Zitat Agmon Y, Khandheria BK, Gentile F, Seward JB (1999) Echocardiographic assessment of the left atrial appendage. J Am Coll Cardiol 34(7):1867–1877CrossRefPubMed Agmon Y, Khandheria BK, Gentile F, Seward JB (1999) Echocardiographic assessment of the left atrial appendage. J Am Coll Cardiol 34(7):1867–1877CrossRefPubMed
23.
Zurück zum Zitat Beppu S, Nimura Y, Sakakibara H, Nagata S, Park YD, Izumi S (1985) Smoke-like echo in the left atrial cavity in mitral valve disease: its features and significance. J Am Coll Cardiol 6(4):744–749CrossRefPubMed Beppu S, Nimura Y, Sakakibara H, Nagata S, Park YD, Izumi S (1985) Smoke-like echo in the left atrial cavity in mitral valve disease: its features and significance. J Am Coll Cardiol 6(4):744–749CrossRefPubMed
24.
Zurück zum Zitat Siostrzonek P, Koppensteiner R, Gossinger H, Zangeneh M, Heinz G, Kreiner G, Stumpflen A, Buxbaum P, Ehringer H, Mosslacher H (1993) Hemodynamic and hemorheologic determinants of left atrial spontaneous echo contrast and thrombus formation in patients with idiopathic dilated cardiomyopathy. Am Heart J 125(2 Pt 1):430–434CrossRefPubMed Siostrzonek P, Koppensteiner R, Gossinger H, Zangeneh M, Heinz G, Kreiner G, Stumpflen A, Buxbaum P, Ehringer H, Mosslacher H (1993) Hemodynamic and hemorheologic determinants of left atrial spontaneous echo contrast and thrombus formation in patients with idiopathic dilated cardiomyopathy. Am Heart J 125(2 Pt 1):430–434CrossRefPubMed
25.
Zurück zum Zitat Zabalgoitia M, Halperin JL, Pearce LA, Blackshear JL, Asinger RW, Hart RG (1998) Transesophageal echocardiographic correlates of clinical risk of thromboembolism in nonvalvular atrial fibrillation. J Am Coll Cardiol 31(7):1622–1626CrossRefPubMed Zabalgoitia M, Halperin JL, Pearce LA, Blackshear JL, Asinger RW, Hart RG (1998) Transesophageal echocardiographic correlates of clinical risk of thromboembolism in nonvalvular atrial fibrillation. J Am Coll Cardiol 31(7):1622–1626CrossRefPubMed
26.
Zurück zum Zitat Fatkin D, Kelly RP, Feneley MP (1994) Relations between left atrial appendage blood flow velocity, spontaneous echocardiographic contrast and thromboembolic risk in vivo. J Am Coll Cardiol 23(4):961–969CrossRefPubMed Fatkin D, Kelly RP, Feneley MP (1994) Relations between left atrial appendage blood flow velocity, spontaneous echocardiographic contrast and thromboembolic risk in vivo. J Am Coll Cardiol 23(4):961–969CrossRefPubMed
27.
Zurück zum Zitat Badano LP, Kolias TJ, Muraru D, Abraham TP, Aurigemma G, Edvardsen T, D’Hooge J, Donal E, Fraser AG, Marwick T, Mertens L, Popescu BA, Sengupta PP, Lancellotti P, Thomas JD, Voigt JU (2018) Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 19(6):591–600CrossRefPubMed Badano LP, Kolias TJ, Muraru D, Abraham TP, Aurigemma G, Edvardsen T, D’Hooge J, Donal E, Fraser AG, Marwick T, Mertens L, Popescu BA, Sengupta PP, Lancellotti P, Thomas JD, Voigt JU (2018) Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 19(6):591–600CrossRefPubMed
28.
Zurück zum Zitat Pathan F, D’Elia N, Nolan MT, Marwick TH, Negishi K (2017) Normal ranges of left atrial strain by speckle-tracking echocardiography: a systematic review and meta-analysis. J Am Soc Echocardiogr 30(1):59-70 e58CrossRefPubMed Pathan F, D’Elia N, Nolan MT, Marwick TH, Negishi K (2017) Normal ranges of left atrial strain by speckle-tracking echocardiography: a systematic review and meta-analysis. J Am Soc Echocardiogr 30(1):59-70 e58CrossRefPubMed
29.
Zurück zum Zitat Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A, Collaborators developing the Japanese equation for estimated GFR (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53(6):982–992CrossRefPubMed Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A, Collaborators developing the Japanese equation for estimated GFR (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53(6):982–992CrossRefPubMed
30.
Zurück zum Zitat Handke M, Harloff A, Hetzel A, Olschewski M, Bode C, Geibel A (2005) Left atrial appendage flow velocity as a quantitative surrogate parameter for thromboembolic risk: determinants and relationship to spontaneous echocontrast and thrombus formation–a transesophageal echocardiographic study in 500 patients with cerebral ischemia. J Am Soc Echocardiogr 18(12):1366–1372CrossRefPubMed Handke M, Harloff A, Hetzel A, Olschewski M, Bode C, Geibel A (2005) Left atrial appendage flow velocity as a quantitative surrogate parameter for thromboembolic risk: determinants and relationship to spontaneous echocontrast and thrombus formation–a transesophageal echocardiographic study in 500 patients with cerebral ischemia. J Am Soc Echocardiogr 18(12):1366–1372CrossRefPubMed
31.
Zurück zum Zitat Obokata M, Negishi K, Kurosawa K, Tateno R, Tange S, Arai M, Amano M, Kurabayashi M (2014) Left atrial strain provides incremental value for embolism risk stratification over CHA(2)DS(2)-VASc score and indicates prognostic impact in patients with atrial fibrillation. J Am Soc Echocardiogr 27(7):709-716 e704CrossRefPubMed Obokata M, Negishi K, Kurosawa K, Tateno R, Tange S, Arai M, Amano M, Kurabayashi M (2014) Left atrial strain provides incremental value for embolism risk stratification over CHA(2)DS(2)-VASc score and indicates prognostic impact in patients with atrial fibrillation. J Am Soc Echocardiogr 27(7):709-716 e704CrossRefPubMed
32.
Zurück zum Zitat Hewing B, Theres L, Spethmann S, Stangl K, Dreger H, Knebel F (2017) Left atrial strain predicts hemodynamic parameters in cardiovascular patients. Echocardiography 34(8):1170–1178CrossRefPubMed Hewing B, Theres L, Spethmann S, Stangl K, Dreger H, Knebel F (2017) Left atrial strain predicts hemodynamic parameters in cardiovascular patients. Echocardiography 34(8):1170–1178CrossRefPubMed
33.
Zurück zum Zitat Singh A, Medvedofsky D, Mediratta A, Balaney B, Kruse E, Ciszek B, Shah AP, Blair JE, Maffessanti F, Addetia K, Mor-Avi V, Lang RM (2019) Peak left atrial strain as a single measure for the non-invasive assessment of left ventricular filling pressures. Int J Cardiovasc Imaging 35(1):23–32CrossRefPubMed Singh A, Medvedofsky D, Mediratta A, Balaney B, Kruse E, Ciszek B, Shah AP, Blair JE, Maffessanti F, Addetia K, Mor-Avi V, Lang RM (2019) Peak left atrial strain as a single measure for the non-invasive assessment of left ventricular filling pressures. Int J Cardiovasc Imaging 35(1):23–32CrossRefPubMed
34.
Zurück zum Zitat Motoki H, Negishi K, Kusunose K, Popovic ZB, Bhargava M, Wazni OM, Saliba WI, Chung MK, Marwick TH, Klein AL (2014) Global left atrial strain in the prediction of sinus rhythm maintenance after catheter ablation for atrial fibrillation. J Am Soc Echocardiogr 27(11):1184–1192CrossRefPubMedPubMedCentral Motoki H, Negishi K, Kusunose K, Popovic ZB, Bhargava M, Wazni OM, Saliba WI, Chung MK, Marwick TH, Klein AL (2014) Global left atrial strain in the prediction of sinus rhythm maintenance after catheter ablation for atrial fibrillation. J Am Soc Echocardiogr 27(11):1184–1192CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Singh A, Addetia K, Maffessanti F, Mor-Avi V, Lang RM (2017) LA strain for categorization of LV diastolic dysfunction. JACC Cardiovasc Imaging 10(7):735–743CrossRefPubMed Singh A, Addetia K, Maffessanti F, Mor-Avi V, Lang RM (2017) LA strain for categorization of LV diastolic dysfunction. JACC Cardiovasc Imaging 10(7):735–743CrossRefPubMed
Metadaten
Titel
Left atrial strain time integral evaluated by two-dimensional speckle tracking predicts left atrial appendage dysfunction in patients with acute ischemic stroke
verfasst von
Aoi Takahata
Tetsu Watanabe
Masahiro Wanezaki
Takayuki Nagai
Shunsuke Edamura
Hayato Tsuchiya
Harutoshi Tamura
Satoshi Nishiyama
Yoichiro Otaki
Daisuke Kutsuzawa
Shigehiko Kato
Takanori Arimoto
Hiroki Takahashi
Masafumi Watanabe
Publikationsdatum
06.02.2024
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 5/2024
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-023-02355-5

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Neu im Fachgebiet Kardiologie

Vier-Punkte-Regel zum Abbruch der Reanimation

Für die Beendigung von Wiederbelebungsmaßnahmen nach Herzstillstand in Kliniken schlägt ein internationales Team eine Vier-Punkte-Regel vor. Deren Zuverlässigkeit wurde in einer skandinavischen Kohortenstudie validiert.

Welche Faktoren das Demenzrisiko bei Vorhofflimmern beeinflussen

In einer Metaanalyse wurden elf Faktoren identifiziert, die bei Vorhofflimmern(VHF)-Patienten mit dem Risiko für eine kognitive Beeinträchtigung assoziiert sind. Im besten Fall eröffnet sich damit ein Weg für die Prävention.

TSAT bester Marker für Herzinsuffizienz-Prognose?

Um Herzinsuffizienz-Kranke zu erkennen, die aufgrund eines Eisenmangels eine schlechtere Prognose haben, scheint die Transferrin-Sättigung (TSAT) besonders geeignet zu sein. Sie ist offenbar aussagekräftiger als der Ferritinwert.

Prävention von Aortenaneurysmen: Auf Lipidsenker setzen?

Lipidsenker scheinen einen signifikanten Schutz vor Erkrankungen der Aorta zu bieten. Das geht aus einer umfangreichen Analyse von Biobank- und Pharmakovigilanz-Daten hervor. Antihypertensiva bewirken da offenbar weniger.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.