The relationship between atrial electromechanical delay and left atrial mechanical function in stroke patients

Objective: The aim of this study was to evaluate the relationship between atrial electromechanical delay (EMD) measured with tissue Doppler imaging (TDI) and left atrial (LA) mechanical functions in patients with ischemic stroke and compare them with healthy controls. Methods: Thirty patients with ischemic stroke were enrolled into this cross-sectional, observational study. The control group consisted of 35 age- and gender-matched apparently healthy individuals patients. Acute cerebral infarcts of probable embolic origin were diagnosed via imaging and were confirmed by a neurologist. Echocardiographically, time intervals from the beginning of P wave to beginning of A wave from the lateral and septal mitral and right ventricular tricuspid annuli in TDI were recorded. The differences between these intervals gave the mechanical delays (inter- and intra-atrial). Left atrial (LA) volumes were measured using the biplane area-length method, and LA mechanical function parameters were calculated. Statistical analysis was performed using student's t-test, chi-squared test, and Pearson's test. Results: The laboratory and clinical characteristics were similar in the two groups. Increased left atrial EMD (21.36 +/- 10.38 ms versus 11.74 +/- 6.06 ms, p<0.001), right atrial EMD (13.66 +/- 8.62 ms versus 9.66 +/- 6.81 ms, p=0.040), and interatrial EMD (35.03 +/- 9.95 ms versus 21.40 +/- 8.47 ms, p<0.001) were observed in stroke patients as compared to controls. Active LA emptying volume and fraction and passive LA emptying volumes and fraction were similar between controls and stroke patients. Total LA emptying volumes were significantly increased in stroke patients as compared to healthy controls (33.19 +/- 11.99 mL/m(2) versus 27.48 +/- 7.08 mL/m(2), p=0.021). Conclusion: According to the results of our study, interatrial electromechanical delay may be a new predictor for ischemic stroke.