title: Changes in left atrial functional indexes in ischemic stroke patients.
abstract: BACKGROUND
  Increased left atrial (LA) size has been proposed as a predictor of multiple adverse cardiovascular events including stroke. LA dysfunction can occur in the absence of increased LA size. However, the relationship between stroke and changes in LA function is not well known.
  
  
  METHODS
  Patients with acute ischemic stroke and healthy controls were enrolled prospectively. Stroke patients received standard work-ups to determine the etiology of their strokes. Those patients with significant cardiac arrhythmia and heart failure were excluded. All participants received echocardiography examination. Conventional echocardiographic parameters were calculated and cardiac contractile characteristics of the left atrium and left ventricle were analyzed using vector velocity imaging (VVI) technique.
  
  
  RESULTS
  In total, 87 patients with acute ischemic stroke and 20 controls were recruited. The mitral inflow E-wave velocities were lower and A-wave velocities were higher in stroke patients (0.76 ± 0.19 vs. 0.84 ± 0.16, p = 0.048; and 0.97 ± 0.20 vs. 0.76 ± 0.11, p < 0.001 respectively). Stroke patients had a higher active emptying percent of total LA emptying (60.5 ± 19.0%) compared with that in controls (33.5 ± 11.7%, p < 0.001). The minimal LA volume was larger in stroke patients (15.0 ± 10.5 mL) than that in controls (9.9 ± 4.2 mL, p = 0.021), whereas there was no difference in maximal LA volume between stroke patients (37.3 ± 16.5 mL) and controls (33.3 ± 9.9 ml, p = 0.366). The diastolic emptying index of the LA was significantly lower in stroke patients compared with that in controls (61.4 ± 14.6% vs. 70.2 ± 11.0%, p = 0.016). The mitral A-wave velocity and active emptying percent of total LA emptying were significantly higher in all stroke subtypes than those in controls.
  
  
  CONCLUSIONS
  Acute ischemic stroke patients had altered mitral inflow velocities and emptying function of the left atrium. VVI is convenient for quantitative assessment of left atrial volumes and contractile characteristics. Functional changes of LA may occur without significant structural changes. Therefore, the clinical implications of LA functional indexes require further study.
authors.affiliation: Department of Neurology, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, ROC; School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
authors.forename: Chung-Wen
authors.initials: CW
authors.lastname: Chen
authors.forename: Shu-Yi
authors.initials: SY
authors.lastname: Chen
authors.forename: Rey-Nein
authors.initials: RN
authors.lastname: Tung
authors.forename: Ying-Tsung
authors.initials: YT
authors.lastname: Chen
authors.forename: Yi-Ying
authors.initials: YY
authors.lastname: Chiang
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Hsu
mesh_terms: D000368:Aged; D016279:Atrial Function, Left; D002545:Brain Ischemia / Q000503:physiopathology*; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000503:physiopathology*
keywords: atrial function; echocardiography; stroke; vector velocity imaging