Impaired transport function of the left atrium and left atrial appendage in cryptogenic stroke patients with atrial septal aneurysm and without patent foramen ovale

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Abstract

AimsAlthough atrial septal aneurysm (ASA) is frequently combined with patent foramen ovale and associated with cryptogenic stroke (CS), a pathophysiologic correlation between CS and ASA alone has not been fully elucidated. The aims of this study were to assess transport functions of the left atrium (LA) and left atrial appendage (LAA), and to evaluate their relationship in CS subjects with ASA alone.Methods and resultsThis study consisted of 38 CS subjects with ASA alone and 38 matched controls. Transthoracic echocardiography including tissue Doppler imaging was performed in all subjects and transesophageal echocardiography was conducted in CS subjects to assess LAA emptying velocity (LAAev). We also measured soluble P- and E-selectin, interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) as indices of prothrombogenic and proinflammatory activity. Although there were no differences in left ventricular functions and baseline characteristics between the two groups, CS subjects had significantly larger LA volume and lower LA active pump function compared with controls. LAAev was significantly correlated with LA active function. CS subjects had significantly higher E-selectin (P=0.046), IL-6 (P=0.040), and hs-CRP (P=0.001) compared with controls.ConclusionsCompared with controls, LA active pump function was significantly depressed and closely correlated with LAAev in CS subjects with ASA alone. Moreover, plasma levels of E-selectin, IL-6, and hs-CRP were significantly higher in CS subjects with ASA alone. These findings suggest that impaired LA and LAA functions are a crucial pathophysiologic mechanism for ischaemic stroke in subjects with ASA alone.

Original languageEnglish
Pages (from-to)140-147
Number of pages8
JournalEuropean Journal of Echocardiography
Volume12
Issue number2
DOIs
Publication statusPublished - 2011 Feb 1

Fingerprint

Patent Foramen Ovale
Atrial Appendage
Heart Atria
Aneurysm
Stroke
E-Selectin
C-Reactive Protein
Interleukin-6
Left Atrial Function
P-Selectin
Transesophageal Echocardiography
Left Ventricular Function
Echocardiography

Keywords

  • Atrial septal aneurysm
  • Cryptogenic stroke
  • Echocardiography
  • Left atrial function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

@article{1edbc4b556dc4e05ac1681ed35fa7936,
title = "Impaired transport function of the left atrium and left atrial appendage in cryptogenic stroke patients with atrial septal aneurysm and without patent foramen ovale",
abstract = "AimsAlthough atrial septal aneurysm (ASA) is frequently combined with patent foramen ovale and associated with cryptogenic stroke (CS), a pathophysiologic correlation between CS and ASA alone has not been fully elucidated. The aims of this study were to assess transport functions of the left atrium (LA) and left atrial appendage (LAA), and to evaluate their relationship in CS subjects with ASA alone.Methods and resultsThis study consisted of 38 CS subjects with ASA alone and 38 matched controls. Transthoracic echocardiography including tissue Doppler imaging was performed in all subjects and transesophageal echocardiography was conducted in CS subjects to assess LAA emptying velocity (LAAev). We also measured soluble P- and E-selectin, interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) as indices of prothrombogenic and proinflammatory activity. Although there were no differences in left ventricular functions and baseline characteristics between the two groups, CS subjects had significantly larger LA volume and lower LA active pump function compared with controls. LAAev was significantly correlated with LA active function. CS subjects had significantly higher E-selectin (P=0.046), IL-6 (P=0.040), and hs-CRP (P=0.001) compared with controls.ConclusionsCompared with controls, LA active pump function was significantly depressed and closely correlated with LAAev in CS subjects with ASA alone. Moreover, plasma levels of E-selectin, IL-6, and hs-CRP were significantly higher in CS subjects with ASA alone. These findings suggest that impaired LA and LAA functions are a crucial pathophysiologic mechanism for ischaemic stroke in subjects with ASA alone.",
keywords = "Atrial septal aneurysm, Cryptogenic stroke, Echocardiography, Left atrial function",
author = "Na, {Jin Oh} and Shin, {Seung Yong} and Lim, {Hong Euy} and Choi, {Cheol Ung} and Kim, {Seong Hwan} and Kim, {Jin Won} and Kim, {Eung Ju} and Lee, {Eun Mi} and Seung-Woon Rha and Park, {Chang Gyu} and Seo, {Hong Seog} and Oh, {Dong Joo} and Kim, {Young Hoon}",
year = "2011",
month = "2",
day = "1",
doi = "10.1093/ejechocard/jeq164",
language = "English",
volume = "12",
pages = "140--147",
journal = "European Heart Journal Cardiovascular Imaging",
issn = "2047-2404",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Impaired transport function of the left atrium and left atrial appendage in cryptogenic stroke patients with atrial septal aneurysm and without patent foramen ovale

AU - Na, Jin Oh

AU - Shin, Seung Yong

AU - Lim, Hong Euy

AU - Choi, Cheol Ung

AU - Kim, Seong Hwan

AU - Kim, Jin Won

AU - Kim, Eung Ju

AU - Lee, Eun Mi

AU - Rha, Seung-Woon

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

AU - Kim, Young Hoon

PY - 2011/2/1

Y1 - 2011/2/1

N2 - AimsAlthough atrial septal aneurysm (ASA) is frequently combined with patent foramen ovale and associated with cryptogenic stroke (CS), a pathophysiologic correlation between CS and ASA alone has not been fully elucidated. The aims of this study were to assess transport functions of the left atrium (LA) and left atrial appendage (LAA), and to evaluate their relationship in CS subjects with ASA alone.Methods and resultsThis study consisted of 38 CS subjects with ASA alone and 38 matched controls. Transthoracic echocardiography including tissue Doppler imaging was performed in all subjects and transesophageal echocardiography was conducted in CS subjects to assess LAA emptying velocity (LAAev). We also measured soluble P- and E-selectin, interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) as indices of prothrombogenic and proinflammatory activity. Although there were no differences in left ventricular functions and baseline characteristics between the two groups, CS subjects had significantly larger LA volume and lower LA active pump function compared with controls. LAAev was significantly correlated with LA active function. CS subjects had significantly higher E-selectin (P=0.046), IL-6 (P=0.040), and hs-CRP (P=0.001) compared with controls.ConclusionsCompared with controls, LA active pump function was significantly depressed and closely correlated with LAAev in CS subjects with ASA alone. Moreover, plasma levels of E-selectin, IL-6, and hs-CRP were significantly higher in CS subjects with ASA alone. These findings suggest that impaired LA and LAA functions are a crucial pathophysiologic mechanism for ischaemic stroke in subjects with ASA alone.

AB - AimsAlthough atrial septal aneurysm (ASA) is frequently combined with patent foramen ovale and associated with cryptogenic stroke (CS), a pathophysiologic correlation between CS and ASA alone has not been fully elucidated. The aims of this study were to assess transport functions of the left atrium (LA) and left atrial appendage (LAA), and to evaluate their relationship in CS subjects with ASA alone.Methods and resultsThis study consisted of 38 CS subjects with ASA alone and 38 matched controls. Transthoracic echocardiography including tissue Doppler imaging was performed in all subjects and transesophageal echocardiography was conducted in CS subjects to assess LAA emptying velocity (LAAev). We also measured soluble P- and E-selectin, interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) as indices of prothrombogenic and proinflammatory activity. Although there were no differences in left ventricular functions and baseline characteristics between the two groups, CS subjects had significantly larger LA volume and lower LA active pump function compared with controls. LAAev was significantly correlated with LA active function. CS subjects had significantly higher E-selectin (P=0.046), IL-6 (P=0.040), and hs-CRP (P=0.001) compared with controls.ConclusionsCompared with controls, LA active pump function was significantly depressed and closely correlated with LAAev in CS subjects with ASA alone. Moreover, plasma levels of E-selectin, IL-6, and hs-CRP were significantly higher in CS subjects with ASA alone. These findings suggest that impaired LA and LAA functions are a crucial pathophysiologic mechanism for ischaemic stroke in subjects with ASA alone.

KW - Atrial septal aneurysm

KW - Cryptogenic stroke

KW - Echocardiography

KW - Left atrial function

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U2 - 10.1093/ejechocard/jeq164

DO - 10.1093/ejechocard/jeq164

M3 - Article

VL - 12

SP - 140

EP - 147

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

SN - 2047-2404

IS - 2

ER -