Left atrial Functions In Patients with Cryptogenic Stroke: Echocardiographic Speckle Tracking Study

Abstract

Background: The evaluation of left atrial (LA) function through myocardial strain analysis using speckle-tracking echocardiography could uncover subtle abnormalities offering unique insights into LA pathophysiology among individuals with cryptogenic stroke (CS) who have no history of atrial fibrillation. So, the aim of this study was to discover the predictors of stroke in patients who presented with structurally normal heart with sinus rhythm (SR) and uncover the role of left atrial (LA) imaging and to Identify patients who will benefit from antithrombotic therapy. Patients and Methods: This case control study including 155 patients, from them 83 was control (Group I) and 72 was diagnosed with cryptogenic stroke Patients were collected from Neurology Critical Care Unit and Neurology department. The median age of included patients was 63 years. The majority of included patients were females. The studied patients presented with a clinical diagnosis of acute ischemic stroke and probable start of symptoms during the 24 to 48 hours before. Results: there were a statistically significant decrease in LA reservoir strain and contraction strain in group II compared with group I. (p<0.001). Contraction strain ≤13.95% predicted cryptogenic stroke with sensitivity 79.17% and specificity 87.95%. LA volume index more than 36 ml/m2 predicted cryptogenic stroke with sensitivity 69.44% and specificity 100.00%. Reservoir strain ≤23.49 %predicted cryptogenic stroke with sensitivity 83.33% and specificity 89.16%. Conclusion: The discovery of impaired LA functions using LA strain analysis may provide insight into the mechanisms underlying cryptogenic stroke.