AUTHOR=Park Soo-Hyun , Kim Yerim , Lee Minwoo , Lee Sang-Hwa , Bae Jong Seok , Lee Ju-Hun , Kim Tae Jung , Ko Sang-Bae , Jeong Sang-Wuk , Kim Dong-Eog , Ryu Wi-Sun 

TITLE=The usefulness of global longitudinal peak strain and left atrial volume index in predicting atrial fibrillation in patients with ischemic stroke

JOURNAL=Frontiers in Neurology

VOLUME=14

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1287609

DOI=10.3389/fneur.2023.1287609

ISSN=1664-2295

ABSTRACT=<sec><title>Introduction</title><p>Detection of atrial fibrillation (AF) is crucial for preventing recurrence in patients with ischemic stroke. We aimed to examine whether the left atrial volume index (LAVI) and global longitudinal peak strain (GLPS) are associated with AF in patients with ischemic stroke.</p></sec><sec><title>Methods</title><p>We prospectively analyzed 678 consecutive patients with ischemic stroke. LAVI and GLPS were assessed using three-dimensional transthoracic echocardiography with speckle-tracking imaging. Multiple logistic regression was used to evaluate the association of AF with LAVI and GLPS. To evaluate the predictive value of LAVI and GLPS for the presence of AF, we used optimism-corrected c-statistics calculated by 100 bootstrap repetitions and the net reclassification improvement (NRI).</p></sec><sec><title>Results</title><p>The mean patient age was 68 ± 13 years (men, 60%). Patients with AF (18%) were a higher LAVI (41.7 ml/m<sup>2</sup> vs. 74.9 ml/m<sup>2</sup>, <italic>P</italic> &lt; 0.001) and a higher GLPS than those without AF (−14.0 vs. −17.3, <italic>P</italic> &lt; 0.001). Among the 89 patients classified with embolic stroke of unknown source, the probable cardioembolic group had higher GLPS (<italic>n</italic>= 17, −14.6 vs. −18.6, respectively; <italic>P</italic>= 0.014) than the other groups (<italic>n</italic>= 72). Adding GLPS to age, hypertension, and the LAVI significantly improved the NRI, with an overall NRI improvement of 6.1% (<italic>P</italic>= 0.03).</p></sec><sec><title>Discussion</title><p>The LAVI andGLPS with speckle-tracking imaging echocardiography may help identify patients with AF.</p></sec>