Author + information
- Aylin Tugcu,
- Cesare Russo,
- Zhezhen Jin,
- Mitsuhiro Yoshita,
- Shunichi Homma,
- Mitchell Elkind,
- Tatjana Rundek,
- Charles DeCarli,
- Clinton Wright,
- Ralph Sacco and
- Marco Di Tullio
Reduced left atrial (LA) function is associated with cardiovascular events including stroke. Silent brain infarct (SBI) is considered to be a precursor of symptomatic stroke, and has an overall prevalence ranging from 8% to 35% in the general elderly population. It is not known whether LA deformation is associated with SBI. The objective of this study was to assess the relationship of global LA deformation with SBI.
LA strain (?) and strain rate (SR) were assessed by speckle-tracking echocardiography in 270 stroke-free participants from the community-based Cardiovascular Abnormalities and Brain Lesions (CABL) study. The following indexes were measured: global peak positive longitudinal LA? (LA?pos) and SR (LASRpos) during ventricular systole, global peak negative longitudinal SR (LASRearly-neg) during early ventricular diastole, and global peak negative longitudinal SR (LASRlate-neg) during LA contraction. SBI were assessed by brain magnetic resonance imaging. Logistic regression was used to assess the association of global LA? and SR with SBI adjusting for known stroke risk factors.
Mean age of the study group was 68.8 ± 9.5 years (98 men, 172 women). SBI were present in 26/270 (9.6%). Participants with SBI showed significantly reduced LA?pos (21.7 ± 8.6% vs. 27.6 ± 5.5%, p < .0001), LASRpos (0.99 ± 0.38 s-1 vs. 1.25 ± 0.22 s-1, p < .0001), LASRlateneg (−1.39 ± 0.47 s-1 vs. −1.85 ± 0.44 s-1, p < .0001) and LASRearly-neg (−1.26 ± 0.49 s-1 vs. −1.67 ± 0.41 s-1, p < .0001) compared to those without SBI. In multivariate logistic regression analysis adjusting for age, hypertension, diabetes, cigarette smoking, left ventricular mass index, left ventricular ejection fraction and left atrial size, each LA deformation parameter was associated with presence of SBI. The odds ratios (OR) per each SD change were: LA?pos (OR: 2.46, 95% confidence intervals (CI) 1.50-4.03, p<.0003), LASRpos (OR 2.39, 95% CI 1.54-3.71, p = .0001) LASRlateneg (OR 2.80 95% CI 1.57-4.96, p = .0005), and LASRearly-neg (OR 2.90, 95% CI, 1.67-5.01, p = .0001).
Reduced global LA ? and SR are independently associated with an increased risk of silent brain infarcts.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: Echo: Atrial Imaging
Abstract Category: 18. Imaging: Echo
Presentation Number: 1226-333
- 2013 American College of Cardiology Foundation