Associations of left atrial enlargement and the severity and lesion patterns of cardioembolic stroke in patients with nonvalvular atrial fibrillation / 国际脑血管病杂志

Objective To investigate the associations of left atrial enlargement and the severity and lesion patterns of cardioembolic stroke in patients with nonvalvular atrial fibrillation (NVAF).Methods The patients with NVAF diagnosed as cardiogenic stroke within 48 h after onset were enrolled.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the severity of stroke,and ≥ 10 was defined as moderate to severe stroke,and ＜ 10 was defined as mild stroke.Transthoracic echocardiography was used to measure the left atrial diameter.The patients were divided into normal group,mild,moderate,and severe left atrial enlargement groups.According to the lesion patterns revealed by the diffusion weighted imaging,they were divided into either a multiple infarctions group or a single infarction group.Results A total of 137 patients were enrolled,including 86 patients with mild stroke (62.8％),51 with moderate to severe stroke (37.2％),69 with multiple infarctions,and 68 with single infarction (49.6％).Left atrial enlargement was found in 103 cases,in which 35 (25.5％) were mild enlargement,40 (29.2％) were moderate enlargement,and 28 (20.4％) were severe enlargement.Multivariate logistic regression analysis showed that the risk of severe stroke in patients with mild (odds ratio [OR] 15.662,95％ confidence interval [CI] 1.821-134.677;P =0.012),moderate (OR 26.435,95％ CI 3.201-218.319;P =0.002),and severe (OR 75.763,95％ CI 8.536-672.441;P＜0.001) left atrial enlargement were increased significantly,and there were no significant differences in the lesion patterns among the different severity of left atrial enlargement groups (x2 =7.050,P =0.07).Conclusions Left atrial enlargement may be independently associated with the severity of cardiogenic stroke in patients with NVAF,but it is not associated with the lesion patterns.

Left atrial enlargement and ischemic stroke / 国际脑血管病杂志

Left atrial enlargement is an independent risk factor for ischemic stroke and other cardiovascular adverse events. It can affect stroke severity and increase the risk of recurrence. The mechanisms associated with left atrial enlargement and ischemic stroke are not yet clear. It may be associated with atrial thrombosis or co-morbidity, such as atrial fibrillation and hypertension. How to conduct primary and secondary prevention of stroke patients with left atrial enlargement still need further clinical trials to determine.