Assessment of left atrial strain reservoir in patients with ischaemic stroke: a case-control study

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Left atrial (LA) function is considered a seperate marker of cardiovascular disease and its assessment with echocardiography strain analysis has been gaining interest lately. The association of LA characteristics with ischaemic stroke has not been fully understood. Purpose This is a case-control study aiming to identidy differences in LA reservoir strain between ischaemic stroke patients and healthy controls. Methods Consecutive ischaemic stroke patients with preserved left ventricular ejection fraction and sinus rhythm were enrolled in the study. Patients were assessed with 2-dimensional transthoracic echocardiography (apical 4-chamber view) using longitudinal speckle-tracking technique. Non-parametric testing with Mann-Whitney U analysis (new procedure) was carried out to identify differences in the distribution of LA reservoir strain values within the patients group and the controls. A p value of <0.05 was considered statistically significant. Results Sixty-six patients (44 males, 22 females) of a mean age of 49.97 years [minimum = 20, maximum = 61, standard deviation (SD)=8.90] were enrolled in the stroke group. The control group included 39 healthy volunteers (27 males, 12 females) of a mean age of 42.23 years (minimum = 19, maximum = 71, SD = 12.77). In the stroke group, the mean LA reservoir strain was 34.24% (minimum = 5.62, maximum = 71.88%, SD = 10.21%) and the median was 34.06%, whereas the mean and median values of control subjects were 42.84% (minimum = 24.20, maximum = 90, SD = 13.87%) and 39.59% respectively. Mann-Whitneu U analysis (new procedure) showed lower LA strain values in the stroke group (mean rank = 45.29, Mann-Whitney U = 778, p = 0.001) compared to controls (mean rank = 66.05). Conclusion Our study showed that ischaemic stroke patients on sinus rhythm at presentation had impaired LA reservoir strain compared to healthy adults. The role of speckle-tracking echocardiography in assessing LA function and predicting stroke needs to be further evaluated thorougly. Figure Mann-Whitney U testing (new procedure) of left atrial reservoir strain in the stroke group and in healthy controls. Abstract Figure.