Left atrial appendage strain predicts subclinical atrial fibrillation in embolic strokes of undetermined source

Saberniak, Jørg; Skrebelyte-Strom, L; Orstad, Eivind Bjørkan; Hilde, Janne Mykland; Solberg, Magnar Gangås; Rønning, Ole Morten; Kjekshus, Harald; Steine, Kjetil

doi:10.1093/ehjopen/oead039

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…A recent prospective observational study found that the global longitudinal strain (GLS) was lower in patients with acute embolism (p < 0.001) and allowed for the identification of patients with acute embolism (p < 0.0001) when compared to controls [94]. Other studies have similarly found that LAA strain has a similar predictive power for ischaemic stroke compared to the CHADS-VASC2 score [95,96], and others' findings show that LAA strain can predict subclinical AF for patients with cryptogenic stroke [97]. GLS may also be able to predict post-stroke mortality [94].…”

Section: Ttementioning

confidence: 89%

Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review

Thong,

Kong,

Poh

et al. 2023

JCDD

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Cardioembolic strokes account for 20–25% of all ischaemic strokes, with their incidence increasing with age. Cardiac imaging plays a crucial role in identifying cardioembolic causes of stroke, with early and accurate identification affecting treatment, preventing recurrence, and reducing stroke incidence. Echocardiography serves as the mainstay of cardiac evaluation. Transthoracic echocardiography (TTE) is the first line in the basic evaluation of structural heart disorders, valvular disease, vegetations, and intraventricular thrombus. It can be used to measure chamber size and systolic/diastolic function. Trans-oesophageal echocardiography (TOE) yields better results in identifying potential cardioembolic sources of stroke and should be strongly considered, especially if TTE does not yield adequate results. Cardiac computed tomography and cardiac magnetic resonance imaging provide better soft tissue characterisation, high-grade anatomical information, spatial and temporal visualisation, and image reconstruction in multiple planes, especially with contrast. These techniques are useful in cases of inconclusive echocardiograms and can be used to detect and characterise valvular lesions, thrombi, fibrosis, cardiomyopathies, and aortic plaques. Nuclear imaging is not routinely used, but it can be used to assess left-ventricular perfusion, function, and dimensions and may be useful in cases of infective endocarditis. Its use should be considered on a case-by-case basis. The accuracy of each imaging modality depends on the likely source of cardioembolism, and the choice of imaging approach should be tailored to individual patients.

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Section: Ttementioning

confidence: 89%

Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review

Thong,

Kong,

Poh

et al. 2023

JCDD

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“… 16 , 21 The Decryptoring score also used left atrial strain reservoir <25.3% and left atrial strain conduct <10.4%, which is in line with recent evidence showing that left atrial strain is a strong predictor at AF in patients with ESUS. 17 , 28 …”

Section: Discussionmentioning

confidence: 99%

Risk Stratification Tools to Guide a Personalized Approach for Cardiac Monitoring in Embolic Stroke of Undetermined Source

Louka,

Nagraj,

Adamou

et al. 2023

JAHA

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Current recommendations support a personalized sequential approach for cardiac rhythm monitoring to detect atrial fibrillation after embolic stroke of undetermined source. Several risk stratification scores have been proposed to predict the likelihood of atrial fibrillation after embolic stroke of undetermined source. This systematic review aimed to provide a comprehensive overview of the field by identifying risk scores proposed for this purpose, assessing their characteristics and the cohorts in which they were developed and validated, and scrutinizing their predictive performance. We identified 11 risk scores, of which 4 were externally validated. The most frequent variables included were echocardiographic markers and demographics. The areas under the curve ranged between 0.70 and 0.94. The 3 scores with the highest area under the curve were the Decryptoring (0.94 [95% CI, 0.88–1.00]), newly diagnosed atrial fibrillation (0.87 [95% CI, 0.79–0.94]), and AF‐ESUS (Atrial Fibrillation in Embolic Stroke of Undetermined Source) (0.85 [95% CI, 0.80–0.87]), of which only the latter was externally validated. Risk stratification scores can guide a personalized approach for cardiac rhythm monitoring after embolic stroke of undetermined source.

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The PADS atrial fibrillation/flutter prediction score: more evidence needed

Boos

2023

European Journal of Preventive Cardiology

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Left atrial appendage strain predicts subclinical atrial fibrillation in embolic strokes of undetermined source

Cited by 4 publications

References 25 publications

Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review

Multimodal Cardiac Imaging in the Assessment of Patients Who Have Suffered a Cardioembolic Stroke: A Review

Risk Stratification Tools to Guide a Personalized Approach for Cardiac Monitoring in Embolic Stroke of Undetermined Source

The PADS atrial fibrillation/flutter prediction score: more evidence needed

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