on October 6, 2005
Published online before print October 6, 2005, doi: 10.1161/01.STR.0000185682.09981.26
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Submitted on June 27, 2005
From the Departments of Medicine (R.R.S., K.S., S.H., M.R.DiT.) and Neurology (R.L.S.), Columbia-Presbyterian Medical Center, New York, NY; and the Department of Cardiology (S.K.), Texas Heart Institute and Baylor College of Medicine, Houston. * To whom correspondence should be addressed. E-mail: md42{at}columbia.edu.
Background and Purpose--We evaluated the association between electrocardiographic left atrial abnormality (ECG-LAA) and ischemic stroke, especially whether ECG-LAA provides additional prognostic information to that provided by echocardiography. Methods--A population-based, case-control study included 146 patients with first ischemic stroke and 195 age-, gender-, and race/ethnicity-matched community control subjects. ECG-LAA was defined as either P-wave duration >120 ms or P-terminal force in precordial lead V1 (PTFV1) >40 ms·mm. Results--PTFV1 >40 ms·mm was associated with ischemic stroke after adjustment for other stroke risk factors (odds ratio [OR], 2.32; 95% CI, 1.29 to 4.18). The association remained significant after adding echocardiographic left atrial diameter to the model (OR, 2.31; 95% CI, 1.28 to 4.17). PTFV1 was independently associated with stroke in patients in the upper half of echocardiographically determined left ventricular mass (adjusted OR, 4.5; 95% CI, 2.20 to 9.15) but not in those in the lower half (OR, 0.58; 95% CI, 0.20 to 1.65; P=0.0008). Conclusions--ECG-LAA can supplement 2D echocardiography in assessing the risk of ischemic stroke, especially in subjects with increased left ventricular mass.
Accepted on July 18, 2005
Electrocardiographic Left Atrial Abnormalities and Risk of Ischemic Stroke
Shun Kohsaka MD;
Key words: echocardiography • electrocardiography • risk factors • stroke