Evaluation of left atrial function by two-dimensional speckle tracking echocardiography in patients with cryptogenic stroke

Abstract Cryptogenic cerebro-vascular stroke is defined as ischemic without definite etiology in spite of complete work up. It differs from embolic undetermined source (ESUS) which a subgroup including the cardio-embolic sources.We aimed to evaluate left atrial function using two-dimensional speckle tracking echocardiography (2D-STE) possible cause for cryptogenic or predictor subclinical AF.TEE has an important role up and ESUS searching PFO, appendage thrombi atheromatous plaques aortic arch. Patients methods Our retrospective cohort study included 62 patients both sexes with unexplained TIA unit Minia University.After performing TEE, 22 were excluded they proven have cardio-embolism.So, Participants divided into two groups, group I 40 II healthy participants no medical history significance control group.Two-dimensional trans-thoracic performed groups. We used LA diameter PLAX, volume index (LAVI), ejection fraction (LAEF), strain rate during reservoir phase (LASr) LV diastolic dysfunction parameters dysfunction.48 hours ECG rhythm monitoring hospitalization was detection more than 30 s episodes paroxysmal fibrillation.Bilateral carotid duplex ultrasonography also exclusion significant artery stenosis stroke. Results The significantly affected P-value < 0.0001 dysfunction, LAVI, LAEF LASr, 0.001 PLAX. Episodes AF noticed 14 (group Ia, 35%) other 26 called Ib, 65%).We compared Group Ib (healthy controls). There affection 0.011. LASr 0.0001. While, there difference between groups = 0.053.We found that most sensitive specific parameter cardiopathy prediction cut-off point ≤24.5 % 0.0001, then ≤40.5 LAVI least ≥38.5 ml/m2 0.003. Conclusion 2D-STE evaluation after TEE sources cardio-embolism.LA strong even before occurrence AF.Also, independent risk factor AF. are predictors well but less sensitivity specificity LASr.