Are left atrial abnormalities a risk for stroke?
OBJECTIVE
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.


CONCLUSIONS
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.
Khidhir
Amanj J
AJ
Department of Medicine, Rizgary Teaching Hospital, Erbil, Iraq.
Al-Shimmery
Ehsan K
EK
Alwan
Mohammed H
MH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods