title: Relation between left atrial enlargement and stroke subtypes in acute ischemic stroke patients.
abstract: OBJECTIVE
  Increased atrial size is frequently seen in ischemic stroke patients in clinical practice. There is controversy about whether left atrial enlargement (LAE) should be regarded as a risk factor for cerebral infarction. We investigated the association between indexed left atrial volume (LAVI) and conventional stroke risk factors as well as stroke subtypes in acute ischemic stroke patients.
  
  
  METHODS
  One hundred eighty two acute cerebral infarction patients were included in this study. Brain magnetic resonance imaging and transthoracic echocardiography were done for all patients within 30 days of diagnosis of acute cerebral infarction. Echocardiographic LAE was identified when LAVI was more than 27 mL/m(2). Stroke subtypes were classified by the Trial of Org 10171 in acute stroke treatment classification.
  
  
  RESULTS
  There were significant differences between subjects with normal and increased LAVI in prevalence of stroke risk factors including atrial fibrillation (p = 0.001), hypertension (p = 0.000), valvular heart disease (p = 0.011) and previous stroke (p = 0.031). An increased LAVI was associated with cardioembolic subtype with an adjusted odds ratio was 6.749 (p = 0.002) compared with small vessel disease.
  
  
  CONCLUSIONS
  Increased LAVI was more prevalent in those who had cardiovascular risk factors, such as atrial fibrillation, hypertension, valvular heart disease and history of previous stroke. LAE influenced most patients in all subtypes of ischemic stroke but was most prevalent in the cardioembolic stroke subtype. Increased LAVI might be a risk factor of cerebral infarction, especially in patients with cardioembolic stroke subtype.
authors.affiliation: Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Hye-Young
authors.initials: HY
authors.lastname: Shin
authors.forename: In-Hye
authors.initials: IH
authors.lastname: Jeong
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Kang
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Shin
authors.forename: Hyeon-Mi
authors.initials: HM
authors.lastname: Park
authors.forename: Kee-Hyung
authors.initials: KH
authors.lastname: Park
authors.forename: Young-Hee
authors.initials: YH
authors.lastname: Sung
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Shin
authors.forename: Young
authors.initials: Y
authors.lastname: Noh
authors.forename: Yeong-Bae
authors.initials: YB
authors.lastname: Lee
keywords: Echocardiography; Ischemic stroke; Left atrial enlargement; Stroke subtype