THE ASSOCIATION OF LEFT ATRIAL ENLARGEMENT IN DIFFERENT SUBTYPES OF ISCHEMIC STROKE BASED ON TOAST CLASSIFICATION

Dr. Pushpendra N Renjen; Dr. Rahul Saini; Dr. Rajeev Kumar Rajput; Dr. Dinesh Chaudhari

Volume : IX, Issue : V, May - 2020

THE ASSOCIATION OF LEFT ATRIAL ENLARGEMENT IN DIFFERENT SUBTYPES OF ISCHEMIC STROKE BASED ON TOAST CLASSIFICATION

Dr. Pushpendra N Renjen, Dr. Rahul Saini, Dr. Rajeev Kumar Rajput, Dr. Dinesh Chaudhari

Abstract :

Background and Purpose: LAE related rhythm disturbance that characterize atrial fiillation is also associated with other atrial derangement such as endothelial dysfunction and impaired myocyte function. The role of LAE in acute cereal infarction patient is not sufficiently described in literature. Hence this study was undertaken to look for the frequency of left atrial enlargement in acute stroke subtypes. Methods: 154 patients with acute ischemic stroke admitted during the study period (June 2016 to March 18) were included. Using clinical data, radiological images and investigation results, stroke subtype of each patient was determined based TOAST criteria. P wave morphology in lead V1 of ECG was evaluated in each patient to look for left atrial enlargement and PTFV1 > 4,000 microvolt ms was considered to be left atrial enlargement by ECG voltage criteria. Results: Out of 154 patients, 64 (41.5%) had LAE. Indexed LA diameter was significantly (p=0.001) higher in Cardio embolic group (2.67�0.30) than other groups. LAE was most frequent in the cardio embolic group (40.6%) followed by undetermined cause group (35.9%). Conclusions: Second Highest frequency of LAE found in undermined group raises the possibility cardiogenic origin of stroke, at least in some of these patients. Further studies may be worthwhile to determine optimal markers of atrial cardiopathy and the effect of anticoagulant therapy in patients with conclusive evidence of atrial cardiopathy, but no clear evidence of AF.