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Erschienen in: The International Journal of Cardiovascular Imaging 12/2017

01.12.2017 | Original Paper

Usefulness of left ventricular speckle tracking echocardiography and novel measures of left atrial structure and function in diagnosing paroxysmal atrial fibrillation in ischemic stroke and transient ischemic attack patients

verfasst von: Kristoffer Grundtvig Skaarup, Hanne Christensen, Nis Høst, Masti Mahdy Mahmoud, Christian Ovesen, Flemming Javier Olsen, Jan Skov Jensen, Tor Biering-Sørensen

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 12/2017

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Abstract

Asymptomatic paroxysmal atrial fibrillation (PAF) is often assumed to be the cause of cryptogenic ischemic strokes (IS) and transient ischemic attacks (TIA). We examined the usefulness of measures obtained by 2D speckle tracking echocardiography and novel left atrial measurements, in the diagnosis of PAF in patients with IS and TIA. We retrospectively included 205 patients who after acute IS or TIA underwent an echocardiogram in sinus rhythm. Patients were designated as PAF-patients if they had one or more reported incidents of AF before or after their echocardiographic examination. None of the conventional echocardiographic parameters were significantly associated with PAF. Of the speckle tracking measurements, only early diastolic strain rate (0.7±0.2 s−1 vs. 0.8±0.3 s−1, p = 0.048) and global longitudinal displacement (GLD) (3.15 ± 1.40 mm vs. 3.87 ± 1.56 mm, p = 0.007) proved significantly different. Of the left atrial parameters both minimal and maximal left atrium volume divided by left ventricular length (min LAV/LVL and max LAV/LVL, respectively) were significantly impaired (min LAV/LVL: 3.7 ± 2.1 cm2 vs. 2.8 ± 1.11 cm2, p = 0.012; max LAV/LVL: 6.6 ± 3.1 cm2 vs. 5.6 ± 1.7 cm2, p = 0.012). GLD, min max LAV/LVL proved significant after adjustment for age, gender, CHA2DS2-VASc and NIHSS. By combining information regarding age, GLD, min and max LAV/LVL the diagnostic accuracy of PAF improved, resulting in a significantly increased area under the curve (p = 0.037). In patients with IS and TIA GLD, min and max LAV/LVL were independently associated with the presence of PAF.
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Metadaten
Titel
Usefulness of left ventricular speckle tracking echocardiography and novel measures of left atrial structure and function in diagnosing paroxysmal atrial fibrillation in ischemic stroke and transient ischemic attack patients
verfasst von
Kristoffer Grundtvig Skaarup
Hanne Christensen
Nis Høst
Masti Mahdy Mahmoud
Christian Ovesen
Flemming Javier Olsen
Jan Skov Jensen
Tor Biering-Sørensen
Publikationsdatum
01.12.2017
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 12/2017
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-017-1204-1

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