Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta‐Analysis
Background Left atrial (LA) fibrosis is a marker of atrial cardiomyopathy and has been reported to be associated with both atrial fibrillation and ischemic stroke. Elucidating this relationship is clinically important as LA fibrosis could serve as a surrogate biomarker of LA cardiomyopathy. The obje...
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| Format: | Article |
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Wiley
2024-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.033059 |
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| author | Jin Hean Koh Lincoln Kai En Lim Ying Kiat Tan Claire Goh Yao Hao Teo Jamie Sin Ying Ho Mayank Dalakoti Mark Yan Yee Chan Ching‐Hui Sia Leonard Leong Litt Yeo Benjamin Yong Qiang Tan |
| author_facet | Jin Hean Koh Lincoln Kai En Lim Ying Kiat Tan Claire Goh Yao Hao Teo Jamie Sin Ying Ho Mayank Dalakoti Mark Yan Yee Chan Ching‐Hui Sia Leonard Leong Litt Yeo Benjamin Yong Qiang Tan |
| author_sort | Jin Hean Koh |
| collection | DOAJ |
| description | Background Left atrial (LA) fibrosis is a marker of atrial cardiomyopathy and has been reported to be associated with both atrial fibrillation and ischemic stroke. Elucidating this relationship is clinically important as LA fibrosis could serve as a surrogate biomarker of LA cardiomyopathy. The objective of this study is to investigate the association of LA fibrosis and embolic stroke of undetermined source (ESUS) using cardiac magnetic resonance imaging. Methods and Results Following an International Prospective Register of Systematic Reviews‐registered protocol, 3 blinded reviewers performed a systematic review for studies that quantified the degree of LA fibrosis in patients with ESUS as compared with healthy patients from inception to February 2024. A meta‐analysis was conducted in the mean difference. From 7 studies (705 patients), there was a significantly higher degree of LA fibrosis in patients with ESUS compared with healthy controls (MD, 5.71% [95% CI, 3.55%–7.87%], P<0.01). The degree of LA fibrosis was significantly higher in patients with atrial fibrillation than healthy controls (MD, 8.22% [95% CI, 5.62%–10.83%], P<0.01). A similar degree of LA fibrosis was observed in patients with ESUS compared with patients with atrial fibrillation (MD, −0.92% [95% CI, −2.29% to 0.44%], P=0.35). Conclusions A significantly higher degree of LA fibrosis was found in patients with ESUS as compared with healthy controls. This suggests that LA fibrosis may play a significant role in the pathogenesis of ESUS. Further research is warranted to investigate LA fibrosis as a surrogate biomarker of atrial cardiomyopathy and recurrent stroke risk in patients with ESUS. |
| format | Article |
| id | doaj-art-d1ae83ebe6cb4d919cb21251ce2eff6d |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-d1ae83ebe6cb4d919cb21251ce2eff6d2025-08-20T02:07:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-09-01131710.1161/JAHA.123.033059Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta‐AnalysisJin Hean Koh0Lincoln Kai En Lim1Ying Kiat Tan2Claire Goh3Yao Hao Teo4Jamie Sin Ying Ho5Mayank Dalakoti6Mark Yan Yee Chan7Ching‐Hui Sia8Leonard Leong Litt Yeo9Benjamin Yong Qiang Tan10Yong Loo Lin School of Medicine National University of Singapore Singapore City SingaporeYong Loo Lin School of Medicine National University of Singapore Singapore City SingaporeYong Loo Lin School of Medicine National University of Singapore Singapore City SingaporeYong Loo Lin School of Medicine National University of Singapore Singapore City SingaporeYong Loo Lin School of Medicine National University of Singapore Singapore City SingaporeDepartment of Medicine National University Health System Singapore City SingaporeDepartment of Cardiology National University Heart Centre Singapore City SingaporeYong Loo Lin School of Medicine National University of Singapore Singapore City SingaporeYong Loo Lin School of Medicine National University of Singapore Singapore City SingaporeYong Loo Lin School of Medicine National University of Singapore Singapore City SingaporeYong Loo Lin School of Medicine National University of Singapore Singapore City SingaporeBackground Left atrial (LA) fibrosis is a marker of atrial cardiomyopathy and has been reported to be associated with both atrial fibrillation and ischemic stroke. Elucidating this relationship is clinically important as LA fibrosis could serve as a surrogate biomarker of LA cardiomyopathy. The objective of this study is to investigate the association of LA fibrosis and embolic stroke of undetermined source (ESUS) using cardiac magnetic resonance imaging. Methods and Results Following an International Prospective Register of Systematic Reviews‐registered protocol, 3 blinded reviewers performed a systematic review for studies that quantified the degree of LA fibrosis in patients with ESUS as compared with healthy patients from inception to February 2024. A meta‐analysis was conducted in the mean difference. From 7 studies (705 patients), there was a significantly higher degree of LA fibrosis in patients with ESUS compared with healthy controls (MD, 5.71% [95% CI, 3.55%–7.87%], P<0.01). The degree of LA fibrosis was significantly higher in patients with atrial fibrillation than healthy controls (MD, 8.22% [95% CI, 5.62%–10.83%], P<0.01). A similar degree of LA fibrosis was observed in patients with ESUS compared with patients with atrial fibrillation (MD, −0.92% [95% CI, −2.29% to 0.44%], P=0.35). Conclusions A significantly higher degree of LA fibrosis was found in patients with ESUS as compared with healthy controls. This suggests that LA fibrosis may play a significant role in the pathogenesis of ESUS. Further research is warranted to investigate LA fibrosis as a surrogate biomarker of atrial cardiomyopathy and recurrent stroke risk in patients with ESUS.https://www.ahajournals.org/doi/10.1161/JAHA.123.033059acute strokeembolic strokeischemic strokemagnetic resonance imagingmodifiable risk factors for stroke |
| spellingShingle | Jin Hean Koh Lincoln Kai En Lim Ying Kiat Tan Claire Goh Yao Hao Teo Jamie Sin Ying Ho Mayank Dalakoti Mark Yan Yee Chan Ching‐Hui Sia Leonard Leong Litt Yeo Benjamin Yong Qiang Tan Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta‐Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute stroke embolic stroke ischemic stroke magnetic resonance imaging modifiable risk factors for stroke |
| title | Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta‐Analysis |
| title_full | Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta‐Analysis |
| title_fullStr | Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta‐Analysis |
| title_full_unstemmed | Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta‐Analysis |
| title_short | Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta‐Analysis |
| title_sort | assessment of left atrial fibrosis by cardiac magnetic resonance imaging in ischemic stroke patients without atrial fibrillation a systematic review and meta analysis |
| topic | acute stroke embolic stroke ischemic stroke magnetic resonance imaging modifiable risk factors for stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.033059 |
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