PDF(Pubmed)
Abstract：
UNASSIGNED: Left atrial (LA) enlargement has been repeatedly shown to be associated with the diagnosis of atrial fibrillation (AF). In clinical practice, several parameters are available to determine LA enlargement: LA diameter index (LADI), LA area index (LAAI), or LA volume index (LAVI). We investigated the predictive power of these individual LA parameters for AF in patients with acute ischemic stroke or transient ischemic attack (TIA).
UNASSIGNED: LAETITIA is a retrospective observational study that reflects the clinical reality of acute stroke care in Germany. Consecutive patient cases with acute ischemic cerebrovascular event (CVE) in 2019 and 2020 were identified from the Mannheim stroke database. Predictive power of each LA parameter was determined by the area under the curve (AUC) of receiver operating characteristic curves. A cutoff value was determined. A multiple logistic regression analysis was performed to confirm the strongest LA parameter as an independent predictor of AF in patients with acute ischemic CVE.
UNASSIGNED: A total of 1,910 patient cases were included. In all, 82.0% of patients had suffered a stroke and 18.0% had a TIA. Patients presented with a distinct cardiovascular risk profile (reflected by a CHA2DS2-VASc score ≥2 prior to hospital admission in 85.3% of patients) and were moderately affected on admission [median NIHSS score 3 (1; 8)]. In total, 19.5% of patients had pre-existing AF, and 8.0% were newly diagnosed with AF. LAAI had the greatest AUC of 0.748, LADI of 0.706, and LAVI of 0.719 (each p < 0.001 vs. diagonal line; AUC-LAAI vs. AUC-LADI p = 0.030, AUC-LAAI vs. AUC-LAVI p = 0.004). LAAI, increasing NIHSS score on admission, and systolic heart failure were identified as independent predictors of AF in patients with acute ischemic CVE. To achieve a clinically relevant specificity of 70%, a cutoff value of ≥10.3 cm2/m2 was determined for LAAI (sensitivity of 69.8%).
UNASSIGNED: LAAI revealed the best prediction of AF in patients with acute ischemic CVE and was confirmed as an independent risk factor. An LAAI cutoff value of 10.3 cm2/m2 could serve as an inclusion criterion for intensified AF screening in patients with embolic stroke of undetermined source in subsequent studies.
UNASSIGNED: LAETITIA is a retrospective observational study that reflects the clinical reality of acute stroke care in Germany. Consecutive patient cases with acute ischemic cerebrovascular event (CVE) in 2019 and 2020 were identified from the Mannheim stroke database. Predictive power of each LA parameter was determined by the area under the curve (AUC) of receiver operating characteristic curves. A cutoff value was determined. A multiple logistic regression analysis was performed to confirm the strongest LA parameter as an independent predictor of AF in patients with acute ischemic CVE.
UNASSIGNED: A total of 1,910 patient cases were included. In all, 82.0% of patients had suffered a stroke and 18.0% had a TIA. Patients presented with a distinct cardiovascular risk profile (reflected by a CHA2DS2-VASc score ≥2 prior to hospital admission in 85.3% of patients) and were moderately affected on admission [median NIHSS score 3 (1; 8)]. In total, 19.5% of patients had pre-existing AF, and 8.0% were newly diagnosed with AF. LAAI had the greatest AUC of 0.748, LADI of 0.706, and LAVI of 0.719 (each p < 0.001 vs. diagonal line; AUC-LAAI vs. AUC-LADI p = 0.030, AUC-LAAI vs. AUC-LAVI p = 0.004). LAAI, increasing NIHSS score on admission, and systolic heart failure were identified as independent predictors of AF in patients with acute ischemic CVE. To achieve a clinically relevant specificity of 70%, a cutoff value of ≥10.3 cm2/m2 was determined for LAAI (sensitivity of 69.8%).
UNASSIGNED: LAAI revealed the best prediction of AF in patients with acute ischemic CVE and was confirmed as an independent risk factor. An LAAI cutoff value of 10.3 cm2/m2 could serve as an inclusion criterion for intensified AF screening in patients with embolic stroke of undetermined source in subsequent studies.
摘要：
■已反复显示左心房（LA）扩大与心房颤动（AF）的诊断有关。在临床实践中,有几个参数可用于确定LA扩大：LA直径指数(LADI)，洛杉矶地区指数（LAAI），或LA体积指数（LAVI）。我们研究了这些单独的LA参数对急性缺血性中风或短暂性脑缺血发作（TIA）患者AF的预测能力。
■LATITIA是一项回顾性观察性研究，反映了德国急性卒中治疗的临床实际情况。从曼海姆卒中数据库中确定了2019年和2020年连续发生急性缺血性脑血管事件（CVE）的患者病例。每个LA参数的预测能力由接受者工作特征曲线的曲线下面积(AUC)确定。确定了截止值。进行了多元逻辑回归分析，以确认最强的LA参数是急性缺血性CVE患者AF的独立预测因子。
■共纳入1,910例患者病例。总之,82.0%的患者患有中风，18.0%的患者患有TIA。患者具有明显的心血管风险特征（85.3％的患者在入院前CHA2DS2-VASc评分≥2反映），并且在入院时受到中度影响[NIHSS评分中位数3（1;8）]。总的来说,19.5%的患者预先存在房颤，新诊断为房颤的占8.0%。LAAI的AUC最大为0.748，LADI最大为0.706，LAVI最大为0.719（每个p<0.001vs.对角线;AUC-LAAIvs.AUC-LADIp=0.030，AUC-LAAIvs.AUC-LAVIp=0.004)。LAAI,入学时增加NIHSS分数，和收缩性心力衰竭被确定为急性缺血性CVE患者房颤的独立预测因子。为了达到70%的临床相关特异性，LAAI的临界值为≥10.3cm2/m2(灵敏度为69.8%).
■LAAI揭示了急性缺血性CVE患者房颤的最佳预测，并被证实为独立危险因素。在随后的研究中，LAAI的临界值为10.3cm2/m2，可作为强化房颤筛查的纳入标准。
■LATITIA是一项回顾性观察性研究，反映了德国急性卒中治疗的临床实际情况。从曼海姆卒中数据库中确定了2019年和2020年连续发生急性缺血性脑血管事件（CVE）的患者病例。每个LA参数的预测能力由接受者工作特征曲线的曲线下面积(AUC)确定。确定了截止值。进行了多元逻辑回归分析，以确认最强的LA参数是急性缺血性CVE患者AF的独立预测因子。
■共纳入1,910例患者病例。总之,82.0%的患者患有中风，18.0%的患者患有TIA。患者具有明显的心血管风险特征（85.3％的患者在入院前CHA2DS2-VASc评分≥2反映），并且在入院时受到中度影响[NIHSS评分中位数3（1;8）]。总的来说,19.5%的患者预先存在房颤，新诊断为房颤的占8.0%。LAAI的AUC最大为0.748，LADI最大为0.706，LAVI最大为0.719（每个p<0.001vs.对角线;AUC-LAAIvs.AUC-LADIp=0.030，AUC-LAAIvs.AUC-LAVIp=0.004)。LAAI,入学时增加NIHSS分数，和收缩性心力衰竭被确定为急性缺血性CVE患者房颤的独立预测因子。为了达到70%的临床相关特异性，LAAI的临界值为≥10.3cm2/m2(灵敏度为69.8%).
■LAAI揭示了急性缺血性CVE患者房颤的最佳预测，并被证实为独立危险因素。在随后的研究中，LAAI的临界值为10.3cm2/m2，可作为强化房颤筛查的纳入标准。
