Atrial Speckle Tracking Echocardiography for Detecting Atrial Fibrillation in Cryptogenic Stroke: A Meta-Analysis

Mohab Hassib, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX.
Kirolos Barssoum, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX.
Ashish Kumar, Department of Critical Care Medicine, St. John's Medical College, Bangalore, Karnataka, India.
Ankit Agrawal, Division of Hospital Medicine, Cleveland Clinic, Cleveland, OH.
Amit Bansal, UHS Wilson Medical Center, Johnson City, NY.
Rabah Alreshq, Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN.
Majd Al Alhuarrat, Department of Internal Medicine, Jacobi Medical Center - Albert Einstein College of Medicine, Bronx, NY.
Steven Hamilton, Department of Internal Medicine, Jersey Shore University-St Francis Medical Center, 601 Hamilton Ave, Trenton, NJ.
Ahmed Elkhouly, Department of Internal Medicine, Jersey Shore University-St Francis Medical Center, 601 Hamilton Ave, Trenton, NJ.
Muhammad Haq, Department of Internal Medicine, Jersey Shore University-St Francis Medical Center, 601 Hamilton Ave, Trenton, NJ.
Karan Pahuja, Department of Internal Medicine, Jersey Shore University-St Francis Medical Center, 601 Hamilton Ave, Trenton, NJ.
George Bchech, Department of Internal Medicine, Jersey Shore University-St Francis Medical Center, 601 Hamilton Ave, Trenton, NJ.
Claudine Abdou, Vital Care of Houston, Houston, TX.
Khaled Chatila, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX.
Devesh Rai, Rochester Regional HealthFollow
Navin Nanda, Division of Cardiovascular Disease, University of Alabama, Tinsley Harrison Tower, Birmingham, AL.
Wissam Khalife, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX.

Department

Cardiology

Document Type

Article

Publication Title

Current Problems in Cardiology

Abstract

Cryptogenic stroke (CS) accounts for approximately 25% of ischemic stroke cases, with atrial fibrillation (AF) accounting for 30% of CS cases. We investigated the utility of left atrial (LA) speckle-tracking echocardiography in identifying patients at high risk of AF after CS and potentially guiding patients who will benefit from long-term rhythm monitoring devices. Cochrane Library, MEDLINE, and EMBASE were searched for relevant studies. We included studies that examined patients with new CS without a history of AF and further examined LA strain parameters (peak and/or reservoir strain). Continuous data were pooled as a mean difference (MD) comparing patients who developed AF vs no AF. We used the inverse variance method with the DerSimonian-Laird estimator for tau2 and Hartung-Knapp adjustment for random effect analysis. I was used to assess heterogeneity. Thirteen observational studies met our criteria and included 3031 patients with new CS. Of those, 420 patients developed AF on follow-up, and 2611 patients did not develop AF. The AF group vs. no AF had significantly reduced LA reservoir strain (LARS) [MD: -8.61; 95% CI: -10.76, -6.47, I2 = 85%, p < 0.01] at presentation. LARS is significantly lower in patients who developed AF after CS. More studies are needed to validate this data.

First Page

101883

DOI

10.1016/j.cpcardiol.2023.101883

Volume

48

Issue

10

Publication Date

10-1-2023

PubMed ID

37343775

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