143bf4127eb3894ea34951c0851cb464 pmc_34441797.pdf fd8f5443f74607dab42d348d9a72021b858bafc5 pmc_34441797.pdf e36a17cd1f7d0d04a5daac5f72f5cfbf765b410d30aa7fcf3993fc9e0c7cc32c pmc_34441797.pdf Title: Left Atrium Assessment by Speckle Tracking Echocardiography in Cryptogenic Stroke: Seeking Silent Atrial Fibrillation Subject: Silent atrial fibrillation (AF) may be the cause of some cryptogenic strokes (CrS). The aim of the study was to analyse atrial size and function by speckle tracking echocardiography in CrS patients to detect atrial disease. Patients admitted to the hospital due to CrS were included prospectively. Echocardiogram analysis included left atrial ejection fraction (LAEF) and atrial strain. Insertable cardiac monitor was implanted, and AF was defined as an episode of 1 min in the first year after stroke. Left atrial enlargement was defined as indexed volume > 34 mL/m2. Seventy-five consecutive patients were included, aged 76 9 years (arterial hypertension 75%). AF was diagnosed in 49% of cases. The AF group had higher atrial volume and worse atrial function: peak atrial longitudinal strain (PALs) 19.6 5.7% vs. 29.5 7.2%, peak atrial contraction strain (PACs) 8.9 3.9% vs. 16.5 6%, LAEF 46.8 11.5% vs. 60.6 5.2%; p < 0.001. AF was diagnosed in 20 of 53 patients with non-enlarged atrium, and in 18 of them, atrial dysfunction was present. The multivariate logistic regression analysis demonstrated an independent association between detection of AF and atrial volume, LAEF, and strain. Cut-off values were obtained: LAEF < 55%, PALs < 21.4%, and PACs < 12.9%. In conclusion, speckle tracking echocardiography in CrS patients improves silent atrial disease diagnosis, with or without atrial enlargement. Keywords: atrial fibrillation; echocardiography; atrial strain; atrial disease; cryptogenic stroke Author: Mireia Ble, Begoña Benito, Elisa Cuadrado-Godia, Sílvia Pérez-Fernández, Miquel Gómez, Aleksandra Mas-Stachurska, Helena Tizón-Marcos, Lluis Molina, Julio Martí-Almor and Mercè Cladellas Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Aug 9 07:16:50 2021 CEST ModDate: Mon Aug 9 07:22:14 2021 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1601924 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- DUFXDP+VnURWPalladioL Type 1 Custom yes yes no 10 0 RHTFYG+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 MUMRPI+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 EYSJIG+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 CZMDWU+CMSY10 Type 1 Builtin yes yes no 28 0 XYDCIJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 40 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 43 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 65 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 69 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 73 0 AOOOBC+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 91 0 AOOOBD+PalatinoLinotype CID TrueType Identity-H yes yes yes 94 0 AOOOCE+PalatinoLinotype TrueType WinAnsi yes yes no 100 0 AOOODG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 103 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 110 0 AOOOBC+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 123 0 AOOOCE+PalatinoLinotype TrueType WinAnsi yes yes no 126 0 AOOODG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 129 0 AOOOBC+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 140 0 AOOOCE+PalatinoLinotype TrueType WinAnsi yes yes no 143 0 AOOODG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 146 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:06:09 CEST RepresentationInformation: pmc_34441797.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:14:55 CEST Size: 1601924 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 298 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Patient Monitoring Destination: subsection.2.1 Item: Title: Echocardiographic Analysis of Atrial Anatomy and Function Destination: subsection.2.2 Item: Title: Clinical Follow-Up Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Demographic Characteristics and Atrial Fibrillation Destination: subsection.3.1 Item: Title: Atrial Characteristics and AF Detection Destination: subsection.3.2 Item: Title: Atrial Fibrillation Burden and Normal or Enlarged Left Atrium Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Left Atrium Assessment by Speckle Tracking Echocardiography in Cryptogenic Stroke: Seeking Silent Atrial Fibrillation Author: Mireia Ble, Begoña Benito, Elisa Cuadrado-Godia, Sílvia Pérez-Fernández, Miquel Gómez, Aleksandra Mas-Stachurska, Helena Tizón-Marcos, Lluis Molina, Julio Martí-Almor and Mercè Cladellas Subject: Silent atrial fibrillation (AF) may be the cause of some cryptogenic strokes (CrS). The aim of the study was to analyse atrial size and function by speckle tracking echocardiography in CrS patients to detect atrial disease. Patients admitted to the hospital due to CrS were included prospectively. Echocardiogram analysis included left atrial ejection fraction (LAEF) and atrial strain. Insertable cardiac monitor was implanted, and AF was defined as an episode of 1 min in the first year after stroke. Left atrial enlargement was defined as indexed volume > 34 mL/m2. Seventy-five consecutive patients were included, aged 76 9 years (arterial hypertension 75%). AF was diagnosed in 49% of cases. The AF group had higher atrial volume and worse atrial function: peak atrial longitudinal strain (PALs) 19.6 5.7% vs. 29.5 7.2%, peak atrial contraction strain (PACs) 8.9 3.9% vs. 16.5 6%, LAEF 46.8 11.5% vs. 60.6 5.2%; p < 0.001. AF was diagnosed in 20 of 53 patients with non-enlarged atrium, and in 18 of them, atrial dysfunction was present. The multivariate logistic regression analysis demonstrated an independent association between detection of AF and atrial volume, LAEF, and strain. Cut-off values were obtained: LAEF < 55%, PALs < 21.4%, and PACs < 12.9%. In conclusion, speckle tracking echocardiography in CrS patients improves silent atrial disease diagnosis, with or without atrial enlargement. 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