Kohsaka Shun, Sciacca Robert R, Sugioka Kenichi, Sacco Ralph L, Homma Shunichi, Di Tullio Marco R
Department of Cardiology, Texas Heart Institute, Baylor College of Medicine, Houston, Texas, USA.
Stroke. 2005 Nov;36(11):2481-3. doi: 10.1161/01.STR.0000185682.09981.26. Epub 2005 Oct 6.
We evaluated the association between electrocardiographic left atrial abnormality (ECG-LAA) and ischemic stroke, especially whether ECG-LAA provides additional prognostic information to that provided by echocardiography.
A population-based, case-control study included 146 patients with first ischemic stroke and 195 age-, gender-, and race/ethnicity-matched community control subjects. ECG-LAA was defined as either P-wave duration >120 ms or P-terminal force in precordial lead V1 (PTFV1) >40 ms.mm.
PTFV1 >40 ms.mm was associated with ischemic stroke after adjustment for other stroke risk factors (odds ratio [OR], 2.32; 95% CI, 1.29 to 4.18). The association remained significant after adding echocardiographic left atrial diameter to the model (OR, 2.31; 95% CI, 1.28 to 4.17). PTFV1 was independently associated with stroke in patients in the upper half of echocardiographically determined left ventricular mass (adjusted OR, 4.5; 95% CI, 2.20 to 9.15) but not in those in the lower half (OR, 0.58; 95% CI, 0.20 to 1.65; P=0.0008).
ECG-LAA can supplement 2D echocardiography in assessing the risk of ischemic stroke, especially in subjects with increased left ventricular mass.
我们评估了心电图左心房异常（ECG-LAA）与缺血性卒中之间的关联，尤其是ECG-LAA是否能为超声心动图提供的预后信息之外再提供额外的预后信息。
一项基于人群的病例对照研究纳入了146例首次发生缺血性卒中的患者以及195名年龄、性别和种族/民族相匹配的社区对照受试者。ECG-LAA定义为P波时限>120 ms或胸前导联V1的P波终末电势（PTFV1）>-40 ms·mm。
在校正其他卒中危险因素后，PTFV1>-40 ms·mm与缺血性卒中相关（比值比[OR]，2.32；95%可信区间[CI]，1.29至4.18）。在模型中加入超声心动图测定的左心房直径后，该关联仍然显著（OR，2.31；95%CI，1.28至4.17）。在超声心动图测定的左心室质量处于上半部分的患者中，PTFV1与卒中独立相关（校正OR，4.5；95%CI，2.20至9.15），而在左心室质量处于下半部分的患者中则无此关联（OR，0.58；95%CI，0.20至1.65；P=0.0008）。
ECG-LAA在评估缺血性卒中风险方面可补充二维超声心动图，尤其是在左心室质量增加的受试者中。
