Enlarged left atrium may be associated with laterality of anterior circulation cardioembolic stroke

J Stroke Cerebrovasc Dis. 2023 Apr;32(4):106999. doi: 10.1016/j.jstrokecerebrovasdis.2023.106999. Epub 2023 Jan 21.

Abstract

Background: Propensity for lesion lateralization in atrial fibrillation-related cardiac embolic stroke (AF-stroke) remains controversial. In this study, we compared the hemispheric differences among patients with AF-stroke and identified factors associated with lesion laterality.

Methods: We retrospectively reviewed patients with acute AF-stroke admitted from January, 2017 to March, 2022. Patients were grouped based on whether lesions were right or left hemispheric in the anterior circulation territory, based on diffusion-weighted imaging. Factors associated with right-side propensity were analyzed.

Results: Among 385 patients, the mean age was 74±11 years and 52.5 % were male. Right and left hemispheric lesions were observed in 189 (49.1 %) and 196 (50.9%) patients, respectively. In the multivariate analysis, enlarged left atrium (LA) (adjusted odds ratio [aOR]=1.03, 95% confidential interval [CI], 1.007-1.061; p=0.013) and single confluent lesion pattern (aOR= 1.55, 95% CI, 1.012-2.381; p=0.044) were associated with right hemispheric lesions.

Conclusions: Enlarged LA and single confluent lesion pattern were strongly related to right-sided propensity in patients with AF-stroke.

Keywords: Atrial fibrillation; Cardioembolic stroke; Enlarge left atrium; Laterality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / diagnostic imaging
  • Embolic Stroke* / complications
  • Embolic Stroke* / etiology
  • Female
  • Heart Atria / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Stroke* / complications
  • Stroke* / etiology