Usefulness of left ventricular speckle tracking echocardiography and novel measures of left atrial structure and function in diagnosing paroxysmal atrial fibrillation in ischemic stroke and transient ischemic attack patients

The International Journal of Cardiovascular Imaging, Springer Nature, ISSN 1573-0743

Volume 33, 12, 2017

DOI:10.1007/s10554-017-1204-1, Dimensions: pub.1090306927, PMID: 28664480,



  1. (1) Department of Neurology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
  2. (2) Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Kildegårdsvej 28, Post 835, 2900, Copenhagen, Denmark
  3. (3) University of Copenhagen, grid.5254.6, KU
  4. (4) Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark






Asymptomatic paroxysmal atrial fibrillation (PAF) is often assumed to be the cause of cryptogenic ischemic strokes (IS) and transient ischemic attacks (TIA). We examined the usefulness of measures obtained by 2D speckle tracking echocardiography and novel left atrial measurements, in the diagnosis of PAF in patients with IS and TIA. We retrospectively included 205 patients who after acute IS or TIA underwent an echocardiogram in sinus rhythm. Patients were designated as PAF-patients if they had one or more reported incidents of AF before or after their echocardiographic examination. None of the conventional echocardiographic parameters were significantly associated with PAF. Of the speckle tracking measurements, only early diastolic strain rate (0.7±0.2 s-1 vs. 0.8±0.3 s-1, p = 0.048) and global longitudinal displacement (GLD) (3.15 ± 1.40 mm vs. 3.87 ± 1.56 mm, p = 0.007) proved significantly different. Of the left atrial parameters both minimal and maximal left atrium volume divided by left ventricular length (min LAV/LVL and max LAV/LVL, respectively) were significantly impaired (min LAV/LVL: 3.7 ± 2.1 cm2 vs. 2.8 ± 1.11 cm2, p = 0.012; max LAV/LVL: 6.6 ± 3.1 cm2 vs. 5.6 ± 1.7 cm2, p = 0.012). GLD, min max LAV/LVL proved significant after adjustment for age, gender, CHA2DS2-VASc and NIHSS. By combining information regarding age, GLD, min and max LAV/LVL the diagnostic accuracy of PAF improved, resulting in a significantly increased area under the curve (p = 0.037). In patients with IS and TIA GLD, min and max LAV/LVL were independently associated with the presence of PAF.

Research Categories

Main Subject Area

Fields of Research

Links & Metrics

NORA University Profiles

University of Copenhagen

Danish Open Access Indicator

2017: Unused

Research area: Medicine

Danish Bibliometrics Indicator

2017: Level 1

Research area: Medicine

Dimensions Citation Indicators

Times Cited: 7

Field Citation Ratio (FCR): 3.57

Relative Citation ratio (RCR): 0.62