Electrocardiographic left atrial abnormalities and risk of ischemic stroke.
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.
Kohsaka
Shun
S
Department of Cardiology, Texas Heart Institute, Baylor College of Medicine, Houston, Texas, USA.
Sciacca
Robert R
RR
Sugioka
Kenichi
K
Sacco
Ralph L
RL
Homma
Shunichi
S
Di Tullio
Marco R
MR
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*