Park Soo-Hyun, Kim Yerim, Lee Minwoo, Lee Sang-Hwa, Bae Jong Seok, Lee Ju-Hun, Kim Tae Jung, Ko Sang-Bae, Jeong Sang-Wuk, Kim Dong-Eog, Ryu Wi-Sun
Department of Neurology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea.
Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea.
Front Neurol. 2024 Jan 5;14:1287609. doi: 10.3389/fneur.2023.1287609. eCollection 2023.
Detection of atrial fibrillation (AF) is crucial for preventing recurrence in patients with ischemic stroke. We aimed to examine whether the left atrial volume index (LAVI) and global longitudinal peak strain (GLPS) are associated with AF in patients with ischemic stroke.
We prospectively analyzed 678 consecutive patients with ischemic stroke. LAVI and GLPS were assessed using three-dimensional transthoracic echocardiography with speckle-tracking imaging. Multiple logistic regression was used to evaluate the association of AF with LAVI and GLPS. To evaluate the predictive value of LAVI and GLPS for the presence of AF, we used optimism-corrected c-statistics calculated by 100 bootstrap repetitions and the net reclassification improvement (NRI).
The mean patient age was 68 ± 13 years (men, 60%). Patients with AF (18%) were a higher LAVI (41.7 ml/m vs. 74.9 ml/m, < 0.001) and a higher GLPS than those without AF (-14.0 vs. -17.3, < 0.001). Among the 89 patients classified with embolic stroke of unknown source, the probable cardioembolic group had higher GLPS (= 17, -14.6 vs. -18.6, respectively; = 0.014) than the other groups (= 72). Adding GLPS to age, hypertension, and the LAVI significantly improved the NRI, with an overall NRI improvement of 6.1% (= 0.03).
The LAVI andGLPS with speckle-tracking imaging echocardiography may help identify patients with AF.
检测心房颤动（AF）对于预防缺血性脑卒中患者复发至关重要。我们旨在研究左心房容积指数（LAVI）和整体纵向峰值应变（GLPS）是否与缺血性脑卒中患者的AF相关。
我们对678例连续的缺血性脑卒中患者进行了前瞻性分析。使用三维经胸超声心动图斑点追踪成像评估LAVI和GLPS。采用多因素逻辑回归评估AF与LAVI和GLPS的相关性。为了评估LAVI和GLPS对AF存在的预测价值，我们使用通过100次重复自抽样计算的乐观校正c统计量和净重新分类改善（NRI）。
患者的平均年龄为68±13岁（男性占60%）。AF患者（18%）的LAVI较高（41.7 ml/m²对74.9 ml/m²，P<0.001），且GLPS高于无AF患者（-14.0对-17.3，P<0.001）。在89例病因不明的栓塞性脑卒中患者中，可能的心源性栓塞组的GLPS较高（分别为17例，-14.6对-18.6，P = 0.014），高于其他组（72例）。将GLPS添加到年龄、高血压和LAVI中显著改善了NRI，总体NRI改善了6.1%（P = 0.03）。
采用斑点追踪成像超声心动图测量的LAVI和GLPS可能有助于识别AF患者。
