title: Echocardiographic measures of atrial function may predict atrial fibrillation in stroke patients.
abstract: OBJECTIVE
  In patients with a prior stroke or transient ischemic attack (TIA) and atrial fibrillation anticoagulant treatment is indicated. This study's purpose was to investigate if echocardiography can predict unknown AF in patients after stroke.
  
  
  METHODS
  Prospectively, 174 stroke/TIA patients without diagnosed AF underwent echocardiographic evaluation including tissue Doppler imaging (TDI) focusing on functional parameters of the left atrium and left ventricular diastolic function. AF screening was performed during 30 d.
  
  
  RESULTS
  Fifteen patients (8.6%) were diagnosed with AF. Echocardiography in the AF group compared to those without AF, showed larger left atrial volume index (LAVI), (37.2 ± 6.7 vs. 31.6 ± 8.6 ml/m(2), p = 0.018), lower A' velocities in ventricular (5.9 ± 2.2 vs. 7.2 ± 1.6, p = 0.010) and atrial (4.8 ± 1.4 vs. 5.9 ± 1.4, p = 0.013) septa, higher LAVI/A' in ventricular septum (6.7 (5.0-8.7) vs. 4.2 (3.2-5.5), p = 0.001) and atrial septum (8.5 (5.9-11.0) vs. 5.1 (4.1-6.8), p = 0.003). Receiver operating characteristic analyses to detect AF was performed, area under the curve for LAVI was 0.71 (0.61-0.83), p = 0.008, and for LAVI/A' in ventricular septum 0.76 (0.59-0.93), p = 0.006 and atrial septum 0.78 (0.63-0.93), p = 0.002, respectively.
  
  
  CONCLUSIONS
  LAVI and measures of atrial contraction as measured by TDI predict unknown AF in patients after an stroke/TIA and may be used to detect silent AF.
authors.affiliation: a Department of Clinical Sciences, Karolinska Institutet , Danderyd University Hospital Stockholm , Sweden ;|b Department of Medicine , Ersta Hospital , Stockholm , Sweden ;
authors.forename: David
authors.initials: D
authors.lastname: Waldenhjort
authors.affiliation: a Department of Clinical Sciences, Karolinska Institutet , Danderyd University Hospital Stockholm , Sweden ;
authors.forename: Piotr
authors.initials: P
authors.lastname: Sobocinski Doliwa
authors.affiliation: a Department of Clinical Sciences, Karolinska Institutet , Danderyd University Hospital Stockholm , Sweden ;
authors.forename: Mahbubul
authors.initials: M
authors.lastname: Alam
authors.affiliation: a Department of Clinical Sciences, Karolinska Institutet , Danderyd University Hospital Stockholm , Sweden ;
authors.forename: Viveka
authors.initials: V
authors.lastname: Frykman-Kull
authors.affiliation: c Department of Medicine , Halland Hospital , Halmstad , Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Engdahl
authors.affiliation: a Department of Clinical Sciences, Karolinska Institutet , Danderyd University Hospital Stockholm , Sweden ;
authors.forename: Mårten
authors.initials: M
authors.lastname: Rosenqvist
authors.affiliation: a Department of Clinical Sciences, Karolinska Institutet , Danderyd University Hospital Stockholm , Sweden ;
authors.forename: Hans
authors.initials: H
authors.lastname: Persson
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D016279:Atrial Function, Left; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*
keywords: Atrial fibrillation; echocardiography; ischemic stroke; tissue Doppler imaging