The role of the TAPSE/PASP ratio in the prediction of paroxysmal atrial fibrillation in patients with acute ischemic stroke

Abstract

Aims: Atrial fibrillation (AF) remains the most prevalent cause of cardioembolic stroke. Paroxysmal AF (PAF) is often difficult to be diagnosed and is sometimes first detected during embolic stroke. Yet, TAPSE and PASP can be easily revealed in routine transthoracic echocardiography (TTE). Then, the TAPSE/PASP ratio is often shown to have prognostic significance in many cardiac disorders. Nevertheless, the insufficient scholarly knowledge of the relationship between this ratio and the development of PAF became the primary motive of the present study.
 Methods: We carried out this study with 114 patients experiencing acute ischemic stroke without a previous diagnosis of AF. We noted down the patients’ blood parameters and prescribed drugs and calculated TAPSE/PASP ratio relying on their TTE findings. We also recorded the 24-hour heart rhythm findings of each patient through Holter monitoring. After categorizing PAF attacks (i.e.,PAF attack was (not) observed), we explored any statistical relationship between the TAPSE/PASP ratio and the presence of PAF.
 Results: The findings revealed a significant difference between the TAPSE/PASP ratios between the groups with PAF (0.62±0.07) and without PAF (0.77±0.08). Moreover, the receiver operating characteristic (ROC) curve analysis yielded the TAPSE/PASP ratio to demonstrate a diagnostic value in predicting PAF (area under the ROC curve [AUC]=0.89;82.7%; p