New Study Sheds Light on Risk Factors for Atrial Fibrillation and Cardioembolic Stroke

June 23, 2014 — Researchers have announced the results of a four-year study that used 3-D echocardiography to examine the role of mid left atrial cross sectional area (LACSA) as a risk factor for cardioembolic (CE) stroke, atrial fibrillation (AF) and stroke recurrence. Atrial fibrillation is a common heart problem, affecting 2.6 million Americans per year. Strokes resulting from atrial fibrillation and heart disease are typically more severe, as they are associated with significant debilities and higher death rates.

“One of the challenges in treating patients with heart disease and AF is predicting which patients are at higher risk for stroke. Our study identifies a novel imaging sign that can be obtained with echocardiography, a common medical diagnostic tool that uses ultrasound to image the heart, in order to improve our ability to predict which patients are at greater risk for stroke,” said primary investigator Timothy C. Tan, Ph.D., MBBS, clinical and research fellow at Massachusetts General Hospital. “Ultimately, this may help physicians develop more targeted and effective treatment plans for patients with heart disease and AF.”

Tan and his colleagues first used 3-D echo and customized software to analyze a small cohort of 40 ischemic stroke patients, to compare left atrial (LA) remodeling between patients with AF and those without AF. Those results, combined with flow dynamics analysis, allowed the researchers to derive a simplified echocardiographic parameter using 2-D echo measurements to calculate LACSA. Finally, the researchers validated their new formula in a separate group of 1,275 ischemic stroke patients.

Researchers on the study, “Left Atrial Cross Sectional Area, a Marker of Left Atrial Shape, is a Novel Risk Factor for Cardioembolic Stroke and Recurrence of Ischemic Stroke,” included Tan, Octavio Pontes-Neto, Mark Handschumacher, Maria C. Nunes, Yong-Hyun Park, Victoria Piro, Yuan Jiao, Gyeong-Moon Kim, Johanna Helenius, Cashel O'Brien, Xin Zeng, Karen Furie, Hakan Ay and Judy Hung from Massachusetts General Hospital in Boston.

The results of the study were presented at the 25th annual scientific sessions of the American Society of Echocardiography (ASE) in Portland, Ore.

For more information: www.asecho.org