Abstract
Background: Atrial cardiomyopathy is considered to be an important risk factor for cardioembolic stroke. However, little is known how to evaluate the degree of atrial cardiomyopathy. Hypothesis: Left atrial ejection fractions (LAEF) are useful and more sensitive predictors of cardioembolic stroke. Aim; To identify the relationship between LAEF and clinical events such as cardioembolic stroke. Methods: The left atrial appendage closure (LAAC) database of our institution from February 2020 to April 2023 was retrospectively analyzed. The LAEF was calculated from cardiovascular computed tomography (CT) imaging data using the automatic 3-dimensional chamber analysis software. We examined the relationship between the risk of cardioembolic stroke and LAEF. Results: We enrolled 52 consecutive patients who underwent cardiovascular CT before LAAC (age, 75.3±1.1 years; female gender, 26.9%; BMI, 23.3±0.5 kg/m 2 ; CHA 2 DS 2 -VASc score, 4.8±0.2; HAS-BLED score, 3.3±0.1). Of those, 22 (42.3%) patients had histories of cardioembolic stroke. Comparison between patients with and without cardioembolic stroke were shown in Table1. Receiver-operating characteristic curve analysis confirmed that 16.32% was the best cut-off value of LAEF for the history of cardioembolic stroke (AUC = 0.81). In the multivariate analysis, LAEF ≤ 16.32% is the independent predictor for cardioembolic stroke (p-value = 0.0362, respectively) (Table2). Conclusions: Low left atrial motion was potential risk factor for cardioembolic stroke in this population. This result could have a relevant impact on the antithrombotic management of patients and, moreover, LAAC could be the best option for these patients.
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