Abstract
Background: The left atrial septal pouch (LASP), an anatomic variant of the interatrial septum, has uncertain clinical significance. We examined the association between LASP and ischemic stroke subtypes in patients undergoing transesophageal echocardiography (TEE).Methods: We determined the prevalence of LASP among consecutive patients who underwent TEE at our institution. Patients identified with ischemic strokes were further evaluated for stroke subtype using standard and modified criteria from the Trial of Org 10172 in Acute Stroke Treatment (TOAST). We compared the prevalence of LASP in ischemic stroke, cryptogenic stroke, and non-stroke patients using prevalence ratios (PR).Results: The mean age of all 212 patients (including stroke and non-stroke patients) was 57 years. The overall prevalence of LASP was 17% (n = 35). Of the 75 patients who were worked-up for stroke at our institution during study period, we classified 31 as cryptogenic using standard TOAST criteria. The prevalence of LASP among cryptogenic stroke patients (using standard and modified TOAST criteria) was increased compared to the prevalence among other ischemic stroke patients (26 vs. 9%, p = 0.06; PR = 1.8, 95% CI = 1.1–3.1, and 30 vs. 10%, p = 0.04; PR = 2.2, 95% CI = 1.2–4.1, respectively).Conclusion: In this population of relatively young patients, prevalence of LASP was increased in cryptogenic stroke compared to stroke patients of other subtypes. These findings suggest LASP is associated with cryptogenic stroke, which should be verified by future large-scale studies.
Highlights
Upwards of 40% of ischemic strokes are of unknown etiology and are known as “cryptogenic” [1]
The prevalence of left atrial septal pouch (LASP) among cryptogenic stroke patients was increased compared to the prevalence among other ischemic stroke patients (26 vs. 9%, p = 0.06; prevalence ratios (PR) = 1.8, 95% confidence interval (CI) = 1.1–3.1, and 30 vs. 10%, p = 0.04; PR = 2.2, 95% CI = 1.2–4.1, respectively)
In this population of relatively young patients, prevalence of LASP was increased in cryptogenic stroke compared to stroke patients of other subtypes
Summary
Upwards of 40% of ischemic strokes are of unknown etiology and are known as “cryptogenic” [1]. The left atrial septal pouch (LASP), an anatomic variant of the atrial septum [2], may be a site of thrombus formation resulting in cardioembolic stroke. A case-control study demonstrated no association between LASP and ischemic or cryptogenic stroke [8]; that study population was limited to patients older than 50 years of age, and mean age of stroke subjects was over 70 years. The primary aim of the present study was to determine if LASP is associated with cryptogenic stroke in a population that includes young subjects. The left atrial septal pouch (LASP), an anatomic variant of the interatrial septum, has uncertain clinical significance. We examined the association between LASP and ischemic stroke subtypes in patients undergoing transesophageal echocardiography (TEE)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
