Left Atrial Dysfunction in Stroke Patients with Sinus Rhythm: A Case-Control Study

Abstract

Background: Globally, the second leading cause of death and disability is stroke. Many cardiovascular functions may be impaired in patients that have suffered from stroke. A recent study demonstrated that left atrial (LA) function was impaired in stroke patients with atrial fibrillation (AF) (Brann, Day & Bunch, 2012). However, there is limited evidence that supports an association between LA dysfunction in patients with stroke and sinus rhythm abnormalities. As a result, this study assessed the LA function in the sinus rhythm of stroke patients using the speckle tracking echocardiography (STE) and the standard transthoracic echocardiography (TTE) in the United Kingdom. Methodology: The study design was a case-control study, retrospective in nature, with sixty adult patients who had scans performed in the echocardiography laboratory at three different sites. The cases consisted of thirty patients with confirmed stroke in sinus rhythm and the other thirty patients were specified for other causes. The participants were age-, gender-, and race-matched without known stroke and in sinus rhythm. To assess the LA function, logistic regression and Student’s t- tests were utilised to examine the relationship between left atrial strain (LAS) and the presence of stroke. Results: Left atrial reservoir strain (LASr), conduit (LAScd), and the averaged LAS were statistically different among the stroke-affected and non-affected groups (P < 0.05, 95% confidence interval [CI], odds ratios [OR] of 0.67, 0.88, and 0.93, respectively). Moreover, these parameters were dramatically reduced in patients with stroke as compared to the controls. Conclusion: LAS could be a valuable STE tool in stroke stratification, as these findings highlight the importance of cardiac monitoring in patients at risk for stroke.