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The International Journal of Cardiovascular Imaging

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01-04-2019 | Original Paper

Prognostic value of global left atrial peak strain in patients with acute ischemic stroke and no evidence of atrial fibrillation

Authors: Andrea Sonaglioni, Antonio Vincenti, Massimo Baravelli, Elisabetta Rigamonti, Elena Tagliabue, Pietro Bassi, Gian Luigi Nicolosi, Claudio Anzà, Michele Lombardo

Published in: The International Journal of Cardiovascular Imaging | Issue 4/2019

Abstract

Prognostic stratification of acute ischemic stroke (AIS) patients without atrial fibrillation (AF) remains a challenge. Two-dimensional speckle tracking echocardiography (2D-STE) has recently been introduced for dynamic evaluation of left atrial function. However only few data are actually available regarding the application of 2D-STE in AIS patients. The aim of our study was to assess the prognostic role of global left atrial peak strain (GLAPS), measured by 2D-STE, in AIS patients without AF history. Eighty-five AIS patients (mean age 74.1 ± 12.1 years, 49 males) with normal sinus rhythm on ECG and without AF history were enrolled in the prospective study. All patients underwent a complete echocardiographic study with 2D-STE. At 1 year follow-up, we evaluated the occurrence of a composite endpoint of all-cause mortality plus cardiovascular re-hospitalizations. GLAPS was markedly reduced in AIS patients (15.71 ± 4.70%), without any statistically significant difference between the stroke subtypes. At 1-year follow-up, 14 deaths and 17 hospital readmissions were detected in AIS subjects. On a multivariate Cox model, variables independently associated with the occurrence of the composite endpoint were the “Rankin in” Scale (HR 1.69, p = 0.001), GFR (HR 0.98, p = 0.03) and the GLAPS value (HR 0.78, p < 0.0001). A GLAPS value ≤ 15.5% predicted the composite endpoint with sensitivity of 100% and specificity of 80%. A GLAPS value ≤ 15.5% reflects a more advanced atrial cardiomyopathy and might provide a reliable and useful prognostic risk stratification of AIS patients without AF history.

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Title: Prognostic value of global left atrial peak strain in patients with acute ischemic stroke and no evidence of atrial fibrillation
Authors: Andrea Sonaglioni
Antonio Vincenti
Massimo Baravelli
Elisabetta Rigamonti
Elena Tagliabue
Pietro Bassi
Gian Luigi Nicolosi
Claudio Anzà
Michele Lombardo
Publication date: 01-04-2019
Publisher: Springer Netherlands
Published in: The International Journal of Cardiovascular Imaging / Issue 4/2019
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-018-1485-z

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Prognostic value of global left atrial peak strain in patients with acute ischemic stroke and no evidence of atrial fibrillation

Abstract

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