Abstract Details

Title Dilated Left Atrium Is Associated with Multiple Vascular Territory Strokes

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P04 - (-)

Poster/Presentation
Number 082

Objective

Background BACKGROUND: AF is a major cause of AIS and is associated with stroke recurrence and with multivessel territoriy infarcts. Many cryptogenic strokes could be secondary to undiagnosed paroxystic AF.

Design/Methods DESIGN/METHODS: Consecutive patients who presented at Charles-LeMoyne Hospital between October 2006 and June 2011 with a diagnosis of AIS or TIA, without a history of AF nor AF recorded on electrocardiogram, Holter or heart monitoring, who had a transthoracic echocardiography (TTE) and a brain MRI were included. LA dilatation was defined as at least moderate if the LA diameter was ? 47mm for men and ? 43mm for women. The primary outcome was the presence of multivessel territory AIS. Secondary outcomes included all AIS, acute lacunar stroke(s), old lacunar stroke(s) and old non lacunar stroke(s). Three months clinical outcomes such as Modified Rankin score and vascular events were also analyzed.

Results RESULTS: 356 patients were included. Patients with dilated LA had more severe strokes, more hypertension, coronary artery disease, previous stroke or TIA and akinetic areas on TTE. The mean LA diameter was 37mm in the control group and 49 mm in those with enlarged LA (p<0.001). More patients in the LA dilatation group met the primary outcome (20% vs 6%; p=0.023 univariate analysis). The association remained significant after multivariate analysis (p=0.035).

Conclusions CONCLUSIONS: LA dilatation (at least moderate) is associated with multivessel territory strokes on MRI in patients with AIS or TIA without known AF or a confirmed diagnosis of AF. Further studies are necessary to determine if this population might benefit from anticoagulation therapy.

Authors/Disclosures
Marie-Sarah G. Brosseau, MD PRESENTER	No disclosure on file
Brendan J. Kelley, MD, FAAN (University of Texas Southwestern)	Dr. Kelley has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Kelley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Labcorp. Dr. Kelley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Esai.
Aaron L. Boster, MD (Ohiohealth)	Dr. Boster has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for sanofi. Dr. Boster has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for roche. Dr. Boster has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for novartis. Dr. Boster has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Boster has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Serono. The institution of Dr. Boster has received research support from Sanofi. The institution of Dr. Boster has received research support from Roche.
Jean-Martin Boulanger, MD, FRCPC (Jean Martin Boulanger)	No disclosure on file
Leo R. Berger, MD	No disclosure on file

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