title: Relation between Left Atrial Remodeling in Young Patients with Cryptogenic Stroke and Normal Inter-atrial Anatomy.
abstract: OBJECTIVE
  To investigate an association between left atrial (LA) structural and P wave dispersion (PWD) during sinus rhythm, and electrical remodeling in cryptogenic stroke (CS) patients.
  
  
  METHODS
  Forty CS patients and 40 age- and sex-matched healthy controls were enrolled. P wave calculations were based on 12-lead electrocardiography (ECG) at a 50-mm/s-paper speed with an amplitude of 10 mm/mV. Difference between the maximum and minimum P wave duration was the P wave dispersion (PWD=Pmax-Pmin). LA deformation was evaluated by speckle tracking echocardiography within 3 days of the acute event.
  
  
  RESULTS
  PWD was 30.1±7.0 ms and 27.4±3.5 ms in CS and control group (P=0.02), whereas LA maximum volume index [LAVImax] was 20.4±4.5 mL/m(2) and 19.9±2.4 mL/m(2) in CS and control group, respectively (P = 0.04). While global peak LA strain was [pLA-S] (LA reservoir function) 41.4 ± 6.3% and 44.5 ± 7.1% in CS and control group, (P = 0.04), global peak late diastolic strain rate values [pLA-SRa] (LA pump function) were 2.5 ± 0.4% and 2.9 ± 0.5% in CS and control group, respectively (P = 0.001). A mild and a strong negative correlation between global pLA-S and LAVImax (r=-0.49; P<0.01), and between PWD and global pLA-S (r = -0.52; P < 0.01), respectively, was observed in CS.
  
  
  CONCLUSIONS
  Increased PWD is associated with impaired LA mechanical functions and enlargement, and involved in the pathophysiology of AF or an AF-like physiology in CS.
authors.affiliation: Sakarya University School of Medicine, Cardiology Department, Sakarya, Turkey.
authors.forename: Mustafa Gokhan
authors.initials: MG
authors.lastname: Vural
authors.affiliation: Koru Private Hospital, Cardiology Department, Ankara, Turkey.
authors.forename: Suha
authors.initials: S
authors.lastname: Cetin
authors.affiliation: Ankara Numune Research and Education Hospital, Neurology Department, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yilmaz
authors.affiliation: Sakarya University School of Medicine, Cardiology Department, Sakarya, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Akdemir
authors.affiliation: Sakarya University School of Medicine, Cardiology Department, Sakarya, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Gunduz
keywords: Cryptogenic stroke; Echocardiography; P wave dispersion; Paroxysmal atrial fibrillation; Strain