Abstract 4143074: Left Atrial Stiffness in Patients with Cryptogenic Ischemic Stroke

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.