Relationship between left atrial size and stroke in patients with sinus rhythm and preserved systolic function.

Background/aims: Increased left atrial (LA) size has been proposed as a predictor of poor cardiovascular outcome in the elderly. In the present study, we evaluated the relationship between LA size and stroke in subjects of all ages who presented with preserved left ventricular systolic function (LVSF) and sinus rhythm (SR), and investigated the relationships between LA size and other echocardiographic parameters of diastolic function.

Methods: A total of 472 subjects were enrolled in the study (161 men, 311 women) and divided into the stroke group (n=75) and control group (n=397). A conventional echocardiographic study was then performed. Subjects with valvular heart disease, atrial fibrillation, or coronary heart disease were excluded.

Results: The mean subject age was 65.2+/-5.1 years in the stroke group and 65.6+/-5.9 years in the control group. Mitral inflow pattern and E & A velocity showed no significant relationship with stroke (p=NS, p=NS, respectively). Left ventricular mass index and LA dimension were significantly related to stroke (p=0.003, p=0.023, respectively), and hypertension showed a marginal relationship with stroke (p=0.050). Age was not related to stroke in the present study (p=NS).

Conclusions: The LA dimension is significantly related to the incidence of stroke. Therefore, strategies for prevention of stroke in patients with preserved LVSF and SR should be considered in cases of LA enlargement.