title: Electrocardiographic left atrial abnormalities and risk of ischemic stroke.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  ECG-LAA can supplement 2D echocardiography in assessing the risk of ischemic stroke, especially in subjects with increased left ventricular mass.
authors.affiliation: Department of Cardiology, Texas Heart Institute, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Shun
authors.initials: S
authors.lastname: Kohsaka
authors.forename: Robert R
authors.initials: RR
authors.lastname: Sciacca
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugioka
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
authors.forename: Marco R
authors.initials: MR
authors.lastname: Di Tullio
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004452:Echocardiography; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000002:abnormalities* / Q000473:pathology*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012044:Regression Analysis; D012306:Risk; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000473:pathology*