Abstract Body (Do not enter title and authors here): Introduction
Atrial fibrillation (AF) is a risk factor for the development of ischemic stroke. Left atrial (LA) function has been described as a predictor of AF, however, atrial stiffness has been little studied.
Objectives
To determine if there is a difference in left atrial stiffness between patients with ischemic stroke who presented AF and those who did not, the association of stiffness with AF and the stiffness cut-off points.
Methods
An analytical, cross-sectional, single-center study was conducted. Patients older than 18 years with a diagnosis of cryptogenic ischemic stroke who were in sinus rhythm, had no history of atrial fibrillation and underwent an echocardiogram and a 24-hour rhythm Holter during hospitalization were included in the study.
The echocardiograms were performed using a Siemens ACUSON SC 2000 machine with a 2.5 MHz sectorial 4v1c transducer. The reservoir LA strain (LASr) was determined using the VVI technique. The left atrial stiffness was obtained through the ratio E/e’ between the LASr.
Variables were analyzed using chi-square or Student's t-test. ROC curves were used to determine the cutoff points for predicting AF. The association of variables with the development of AF was analyzed using logistic regression.
Results
A total of 96 patients were obtained, of which 35 had documented AF, 16 women and 19 men. Two groups were formed, Group 1: patients with ischemic stroke and AF (35), Group 2: with ischemic stroke without AF (61), which were used as control (Table 1). Among patients with AF, we found they were older and had a higher prevalence of diabetes mellitus, higher E/e' value, LA indexed volume, and greater LA stiffness as well as lower LASr values. LA stiffness (>0.29) and LASr (<36%) were the best predictors of AF in the ROC curves (Image 1) . The association with the development of AF found that LA stiffness was significant in both univariate and multivariate analyses (Table 2).
Conclusion
The stiffness of the left atrium is an easy-to-determine echocardiographic parameter that allows us to predict the presence of atrial fibrillation in patients with an ischemic cerebrovascular event who should have a greater intentional search for atrial fibrillation.