Left Atrial Size and Risk of Stroke in Patients with Sinus Rhythm and Normal Left Ventricular Systolic Function
American Journal of Internal Medicine
Volume 4, Issue 6, November 2016, Pages: 113-116
Received: Oct. 21, 2016;
Accepted: Nov. 2, 2016;
Published: Nov. 25, 2016
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Hanan K. Altalhi, Faculty of Medicine, University of Omar El mukhtar, Albayda, Libya; Department of Internal Medicine, University of Omar El mukhtar, Albayda, Libya
Asgad A. Abdalgbar, Faculty of Medicine, University of Omar El mukhtar, Albayda, Libya; Department of Internal Medicine, University of Omar El mukhtar, Albayda, Libya
Ali Areef Fadhlullah, Faculty of Medicine, University of Omar El mukhtar, Albayda, Libya; Department of Internal Medicine, University of Omar El mukhtar, Albayda, Libya
Increased left atrial (L A) size associated with poor cardiovascular outcome such as development of heart failure, atrial fibrillation (AF) and stroke in the elderly. Objective: The present study was conducted to reevaluate the relationship between la size and stroke in subjects of all ages, not just the elderly who presented with preserved left ventricular systolic function (lvsf) and sinus rhythm (sr). Patients and Methods: This is case control study of 52 patients admitted to the hospital 26 with diagnosis of ischemic stroke (case subject), and 26 patients without ischemic stroke were included as (control subject). The diagnosis of Cerebral infarction was confirmed by a new computer Tomography of Brain All participant underwent the standard examination and testing as well as Echocardiography (measurement of left atrial dimension, Ejection Fraction,Mitral inflow, LV mass), patients with valvular heart disease, atrial fibrillation or coronary disease were excluded. Result: The mean age was 69 ± 18 years in the stroke group and 66 ± 17 years in control group. The LA dimension of stroke group (3.38 ± 0.50 cm) was significantly greater than that of the control group (3.56 ± 0.44cm); P< 0.0001) E&A Velocity showed no significant relation with Stroke (p=NS) Left ventricular mass, left ventricular mass / height and left ventricular mass index were significantly related to stroke (p<0.0001, p= 0.001, p = 0.001, respectively). Conclusion: Echocardiographic left atrial enlargement has prognostic value in identifying a subset of persons at increased risk of stroke.
Hanan K. Altalhi,
Asgad A. Abdalgbar,
Ali Areef Fadhlullah,
Left Atrial Size and Risk of Stroke in Patients with Sinus Rhythm and Normal Left Ventricular Systolic Function, American Journal of Internal Medicine.
Vol. 4, No. 6,
2016, pp. 113-116.
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abhayaratna WP, Seward JB, Appleton CP, et al. Left atrial size: physiologic determinants and clinical applications. J Am coll Cardiol. 2006; 47: 2357-2363.
Barnes ME, Miyasaka Y, Seward JB, et al. Left atrial volume in the prediction of first ischemic stroke in an elderly cohort without atrial fibrillation. Mayo Clin Proc. 2004; 791008-1014.
Basnight MA, Gonzales MS, Keshenovich SC, Appleton CP. Pulmonary venous flow velocity: relation to hemodynamics, mitral flow velocity and left atrial volume, and ejection fraction. J Am Soc Echocardiogr. 1991; 4: 547-558.
Benjamin EJ, D A gostino RB, Belanger AJ, Wolf PA, Levy D. Left atrial size and the risk of stroke and death. Circulation. 1995; 92: 835-841.
Bikkina M, Levy D, Evans JC, et al. Left ventricular mass and risk of stroke in an elderly cohort. JAMA 1994; 272: 33-36.
6evereux RB, Alonso DR, Lutas EM, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardio. 1986; 57: 450-458.
Douglas PS. The left atrium: a biomarker of chronic diastolic dysfunction and cardiovascular disease risk. J Am Coll Cardiol. 2003; 42: 1206-1207.
Kim SB, Lee HJ, Jang HS, Bae BS, Kang HJ, lee BR, Jong BC, Relationship between left atrial size and stroke in patients with sinus rhythm and preserved systolic function. Korean J Intern Med. 2009 Mar 24(1): 24-32.
Lang RM, Bierig M, Devereux RB, et al Recommendation for chamber quantification are part from the American society of Echocardiography and standard committee and chamber quantification writing group, developed in conjunction with European Association of Echocardiography A branch of European society of Cardiology Jam soc Echocardiography 2005; 18: 1440-63.
Lee RJ, Bartzokis T, Yeoh TK, Grogin HR, Choi D, Schnittger I. Enhanced detection of intra cardiac sources of cerebral emboli by trans esophageal echocardiograph. Stroke. 1991; 22: 734-739.
Links Yamashita T, Sekiguchi A, Kato T, et al. Angiotensin type 1 receptor blockade prevents endocardial dysfunction of rapidly paced atria in rats. J Renin Angiotensin Aldosterone Syst. 2007; 8: 127-132.
Miller JT, O Rourke RA, Crawford MH. Left atrial enlargement: an early sign of hypertensive heart disease Am Heart J. 1988; 116: 1048-1051.
Nishimura RA, Tajik AJ. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinicians Rosetta Stone. J Am Coll Cardiol. 1997; 30: 8-18.
Oh JK, Appleton CP,Hatle LK, Nishimura RA, Seward JB, Tajik AJ. The noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography. J Am Soc Echocardioger.1997; 10: 246-270.
Tsang SM, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol.2002; 90: 1284-1289.
Tell GS, Fried L, Hermanson B, Manolio TA, Newman AB, Borhani NO. Recruitment of adults 65 years and older as participants in the Cardiovascular Health Study. Ann Epidemiol. 1993; 3: 358-366.
Weyman AE, principles and practice of echocardiography. Lee and Febiger Publ. 1994; 606.
Wilson PWF, D Agostino rb, Levy D, Belanger AM, Silbershatz H, Kannel WB, prediction of coronary heart disease using risk factor categories. Circulation. 1998: 97: 1837-1847.