Electrocardiographic Left Atrial Abnormalities and Risk of Ischemic Stroke

• Published in: Stroke (1970) Vol. 36; no. 11; pp. 2481 - 2483
• Main Authors: Kohsaka, Shun, Sciacca, Robert R., Sugioka, Kenichi, Sacco, Ralph L., Homma, Shunichi, Di Tullio, Marco R.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.11.2005
• Subjects: Aged; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Case-Control Studies; Echocardiography; Electrocardiography - methods; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Heart Atria - abnormalities; Heart Atria - pathology; Heart Ventricles - pathology; Humans; Ischemia - etiology; Ischemia - pathology; Male; Medical sciences; Middle Aged; Multivariate Analysis; Nervous system (semeiology, syndromes); Neurology; Odds Ratio; Pharmacology. Drug treatments; Regression Analysis; Risk; Risk Factors; Stroke - etiology; Stroke - pathology; Vascular diseases and vascular malformations of the nervous system; Vascular disease; Cerebral infarction; Stroke; Nervous system diseases; risk factors; Echocardiography; Central nervous system disease; Risk factor; Electrocardiography; Cardiovascular disease; Cerebrovascular disease; Cerebral disorder
• ISSN: 0039-2499; 1524-4628; 1524-4628
• DOI: 10.1161/01.STR.0000185682.09981.26

Background and Purpose— We evaluated the association between electrocardiographic left atrial abnormality (ECG-LAA) and ischemic stroke, especially whether ECG-LAA provides additional prognostic information to that provided by echocardiography. Methods— A population-based, case-control study included 146 patients with first ischemic stroke and 195 age-, gender-, and race/ethnicity-matched community control subjects. ECG-LAA was defined as either P-wave duration >120 ms or P-terminal force in precordial lead V 1 (PTFV 1 ) >40 ms·mm. Results— PTFV 1 >40 ms·mm was associated with ischemic stroke after adjustment for other stroke risk factors (odds ratio [OR], 2.32; 95% CI, 1.29 to 4.18). The association remained significant after adding echocardiographic left atrial diameter to the model (OR, 2.31; 95% CI, 1.28 to 4.17). PTFV 1 was independently associated with stroke in patients in the upper half of echocardiographically determined left ventricular mass (adjusted OR, 4.5; 95% CI, 2.20 to 9.15) but not in those in the lower half (OR, 0.58; 95% CI, 0.20 to 1.65; P =0.0008). Conclusions— ECG-LAA can supplement 2D echocardiography in assessing the risk of ischemic stroke, especially in subjects with increased left ventricular mass.