Advanced interatrial block: A predictor of covert atrial fibrillation in embolic stroke of undetermined source

Mendieta, Guiomar; Guasch, Eduard; Restrepo, Danilo Weir; Aristizabal, David; Escobar‐Robledo, Luis Alberto; Llull, Laura; Mont, Lluís; Luna, Antonio; Sitges, Marta

doi:10.1016/j.jelectrocard.2019.11.050

Cited by 19 publications

(13 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The increased frequency of IAB has also been demonstrated in patients with silent brain infarction (11). A recently published article demonstrated an increased prevalence of partial and advanced IAB in patients with embolic stroke with undetermined source (12). In the same study, advanced IAB independently predicted AF (12).…”

Section: Introductionmentioning

confidence: 82%

The Relationship Between Interatrial Block and PASI Score in Patients with Psoriasis

Bakhshaliyev¹,

Enhoş²,

Karaçöp³

et al. 2021

BMB

View full text Add to dashboard Cite

The relationship between the interatrial block (IAB) and atrial fibrillation (AF) has been demonstrated in previous studies. The aim of this study is to investigate the relationship of the IAB with the psoriasis area severity index (PASI) score in psoriasis. Method: Patients with psoriasis who were examined at the cardiology outpatient clinic between January 2017 and May 2019 were retrospectively screened. Two hundred and thirty-eight patients whose electrocardiogram (ECG) and PASI scores were available were included in the study. IAB was defined as if P wave duration was equal to or longer than 120 msec with (advanced IAB) or without (partial IAB) biphasic P morphology in the inferior electrocardiographic leads. The prevalence of IAB in patients with psoriasis and its relationship with the severity of psoriasis were evaluated in the present study. Results: The mean age was 35 (18-62) years, 53% of the study population were male. The median PASI score was 6. IAB was observed in 9.9% of patients. Partial IAB was observed in 6% of patients whereas the prevalence of advanced IAB was 3.0%. No statistically significant difference was observed between the PASI score in patients with and without IAB [6.0 (3.0-13.5) vs. 7.0 (2.5-22.5), respectively, p=0.35]. The mean P wave duration (PWD) was 101 (90-111) ms. No statistically significant correlation was observed between PWD and the PASI score (p=0.35, r=0.06). Conclusion: No significant correlation was identified between IAB and the PASI score, which is used for assessing the severity of psoriasis.

show abstract

Section: Introductionmentioning

confidence: 82%

The Relationship Between Interatrial Block and PASI Score in Patients with Psoriasis

Bakhshaliyev¹,

Enhoş²,

Karaçöp³

et al. 2021

BMB

View full text Add to dashboard Cite

show abstract

“…Interestingly, IAB was also found to be associated with CE stroke in patients with sinus rhythm (59). In ESUS patients, IAB was associated with the diagnosis of subclinical AF and stroke recurrence (95,96). ESVEA [defined as 30 premature atrial contractions (PACs) per hour daily, or any runs of ≥20 PACs] was found to be associated with an increased risk of stroke in a longterm follow-up, independent of AF (97,98).…”

Section: Electrocardiographical Markersmentioning

confidence: 99%

Promising Biomarker Candidates for Cardioembolic Stroke Etiology. A Brief Narrative Review and Current Opinion

2021

View full text Add to dashboard Cite

Determining the cause of stroke is considered one of the main objectives in evaluating a stroke patient in clinical practice. However, ischemic stroke is a heterogeneous disorder and numerous underlying disorders are implicated in its pathogenesis. Although progress has been made in identifying individual stroke etiology, in many cases underlying mechanisms still remain elusive. Since secondary prevention strategies are tailored toward individual stroke mechanisms, patients whose stroke etiology is unknown may not receive optimal preventive treatment. Cardioembolic stroke is commonly defined as cerebral vessel occlusion by distant embolization arising from thrombus formation in the heart. It accounts for the main proportion of ischemic strokes, and its share to stroke etiology is likely to rise even further in future decades. However, it can be challenging to distinguish cardioembolism from other possible etiologies. As personalized medicine advances, stroke researchers' focus is increasingly drawn to etiology-associated biomarkers. They can provide deeper insight regarding specific stroke mechanisms and can help to unravel previously undetected pathologies. Furthermore, etiology-associated biomarkers could play an important role in guiding future stroke prevention strategies. To achieve this, broad validation of promising candidate biomarkers as well as their implementation in well-designed randomized clinical trials is necessary. This review focuses on the most-promising candidates for diagnosis of cardioembolic stroke. It discusses existing evidence for possible clinical applications of these biomarkers, addresses current challenges, and outlines future perspectives.

show abstract

“…As earlier mentioned, an abnormal P-wave axis was associated with increased IS risk independent of CHA 2 DS 2 -VASc score in AF patients ( 32 ). In addition, some small sample studies have shown that advanced interatrial block, diagnosed upon the duration of the P wave and morphology in limb lead ECG, could serve as a marker of atrial electromechanical dysfunction and a surrogate for LA strain reduction, and might act as a predictor of IS in AF patients ( 93 , 94 ).…”

Section: Cardiac Imaging and Ecg Biomarkersmentioning

confidence: 99%

A Review of Biomarkers for Ischemic Stroke Evaluation in Patients With Non-valvular Atrial Fibrillation

Shang

Zhang

Guo

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia worldwide and results in a significantly increased ischemic stroke (IS) risk. IS risk stratification tools are widely being applied to guide anticoagulation treatment decisions and duration in patients with non-valvular AF (NVAF). The CHA2DS2-VASc score is largely validated and currently recommended by renowned guidelines. However, this score is heavily dependent on age, sex, and comorbidities, and exhibits only moderate predictive power. Finding effective and validated clinical biomarkers to assist in personalized IS risk evaluation has become one of the promising directions in the prevention and treatment of NVAF. A number of studies in recent years have explored differentially expressed biomarkers in NVAF patients with and without IS, and the potential role of various biomarkers for prediction or early diagnosis of IS in patients with NVAF. In this review, we describe the clinical application and utility of AF characteristics, cardiac imaging and electrocardiogram markers, arterial stiffness and atherosclerosis-related markers, circulating biomarkers, and novel genetic markers in IS diagnosis and management of patients with NVAF. We conclude that at present, there is no consensus understanding of a desirable biomarker for IS risk stratification in NVAF, and enrolling these biomarkers into extant models also remains challenging. Further prospective cohorts and trials are needed to integrate various clinical risk factors and biomarkers to optimize IS prediction in patients with NVAF. However, we believe that the growing insight into molecular mechanisms and in-depth understanding of existing and emerging biomarkers may further improve the IS risk identification and guide anticoagulation therapy in patients with NVAF.

show abstract

Advanced interatrial block: A predictor of covert atrial fibrillation in embolic stroke of undetermined source

Cited by 19 publications

References 39 publications

The Relationship Between Interatrial Block and PASI Score in Patients with Psoriasis

The Relationship Between Interatrial Block and PASI Score in Patients with Psoriasis

Promising Biomarker Candidates for Cardioembolic Stroke Etiology. A Brief Narrative Review and Current Opinion

A Review of Biomarkers for Ischemic Stroke Evaluation in Patients With Non-valvular Atrial Fibrillation

Contact Info

Product

Resources

About