title: Increased left atrial volume index: potent biomarker for first-ever ischemic stroke.
abstract: OBJECTIVE
  To establish the incidence and correlation of increased left atrial volume index (LAVI) in patients with first-ever ischemic stroke.
  
  
  METHODS
  Using our institution's epidemiological database, we defined a cohort of 432 patients (cases) who underwent transthoracic echocardiography within 60 days of first ischemic stroke between January 1, 1985, and December 31, 1994. Left atrial volume was measured with the biplane area-length method, indexed to body surface area (LAVI, expressed as mL/m(2)). The control group consisted of 416 community residents who underwent transthoracic echocardiography as participants in a stroke risk factor study. Increased LAVI was defined as 28 mL/m(2) or higher. Survival in patients was compared with expected survival among white Minnesotans and was further modeled as a function of age, sex, LAVI, and clinical risk factors.
  
  
  RESULTS
  Among the included 306 patients, 230 (75%) had increased LAVI (mean+/-SD, 49+/-21 mL/m(2)). Patients with increased LAVI were older than those with normal LAVI (mean+/-SD age, 76+/-11 vs 71+/-13 years; P=.003) and had more cardiovascular risk factors (mean+/-SD number, 1.8+/-0.07 vs 1.3+/-0.89; P<.001). Mean LAVI was higher in cases than in age- and sex-matched controls (P<.001). At 5-year follow-up, cases showed excess mortality compared with age-matched controls (P=.001). After variables were adjusted for age, sex, and clinical risk factors, LAVI was independently associated with mortality.
  
  
  CONCLUSIONS
  A useful index for prediction of adverse cardiovascular events, LAVI might also predict first ischemic stroke and subsequent mortality.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. seward@mayo.edu
authors.forename: Kaniz
authors.initials: K
authors.lastname: Fatema
authors.forename: Kent R
authors.initials: KR
authors.lastname: Bailey
authors.forename: George W
authors.initials: GW
authors.lastname: Petty
authors.forename: Irene
authors.initials: I
authors.lastname: Meissner
authors.forename: Martin
authors.initials: M
authors.lastname: Osranek
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Alsaileek
authors.forename: Bijoy K
authors.initials: BK
authors.lastname: Khandheria
authors.forename: Teresa S
authors.initials: TS
authors.lastname: Tsang
authors.forename: James B
authors.initials: JB
authors.lastname: Seward
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000209:etiology / Q000503:physiopathology*; D002306:Cardiac Volume / Q000502:physiology*; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors