Are left atrial abnormalities a risk for stroke?

OBJECTIVES

To show that echocardiographic left atrial enlargement (Echo-LAE) and electrocardiographic left atrial abnormalities (ECG-LAA) may be probable new risk factors for ischemic and hemorrhagic stroke.

METHODS

This descriptive prospective case study included 140 CT or MRI-confirmed hemorrhagic and ischemic stroke patients, who were admitted to Rizgary Teaching Hospital, Erbil, Iraq from January 2008 to January 2009. Twelve lead ECG and 2-dimensional transthoracic Echo were performed for all patients. Electrocardiographic LAA were identified when the P terminal force in lead V1 (PTFV1) was >40 mm.ms. Echocardiographic LAE was identified when the left atrial index was more than 2.3 cm/m2.

RESULTS

Electrocardiographic LAA we resignificantly higher in ischemic stroke patients in comparison with the hemorrhagic strokes. Causes of ECG-LAA were found to be as follows in order of frequency; hypertension (56%), advanced age (47%), coronary artery disease (27%), diabetes mellitus (26%), obesity (21%), valvular heart disease (21%), and 2.6% of patients had no identifiable cause. Echocardiographic-LAE was seen in 34% of ischemic strokes, and 30% of hemorrhagic strokes with no significant difference.

CONCLUSION

Although ECG-LAA (PTFV1>40 mm.ms) is significantly associated with ischemic stroke, it may not be an independent risk factor for stroke as it rarely occurred without other risk factors. Echocardiographic LAE i s associated with both ischemic and hemorrhagic strokes equally.