Left Atrial Volume Index as a Predictor for Large-Vessel Occlusion in Cardiogenic Cerebral Infarction: A Single-Center Cohort Study

• Published in: World neurosurgery Vol. 159; pp. e79 - e83
• Main Authors: Sato, Hirotaka, Saito, Masato, Mitsui, Nobuyuki, Hiroshima, Satoru, Sawada, Jun, Akasaka, Kazumi, Kinoshita, Manabu
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2022
• Subjects: Cerebral Angiography - methods; Cerebral Infarction - complications; Cerebral Infarction - diagnostic imaging; Cohort Studies; Echocardiography; Heart Atria - diagnostic imaging; Humans; Large-vessel occlusion; Left atrial volume index; Left atrium; Predictive Value of Tests; Retrospective Studies; Stroke - etiology; LAV; NIHSS; EF; Large-vessel occlusion; Echocardiography; LVO; AF; MRI; ICA; CCI; DM; MCA; Left atrium; IQR; LAVI; DOAC; LAD; Left atrial volume index; LA
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2021.12.003

The left atrial volume index (LAVI) is considered to be the most accurate index to estimate the size of the left atrium (LA). In this study, we investigated the relationship between LA size measured by LAVI and the occurrence of large-vessel occlusion (LVO) in patients with cardiogenic cerebral infarction (CCI). This retrospective single-center cohort study involved 118 patients with CCI within the internal carotid artery (ICA) or middle cerebral artery regions seen between January 2015 and July 2020. In all patients, the type of CCI was determined according to the Diffusion-Weighted Imaging–Alberta Stroke Program Early Computed Tomography Scores (TOAST) subtype diagnosis criteria. LVO was defined as positive when magnetic resonance imaging and computed tomography angiography showed ICA, M1, or M2 occlusion, with all others defined as non-LVO. Clinical characteristics, including LAVI, were evaluated in the records of several patients to investigate if they were risk factors for developing LVO. Seventy patients (59%) were diagnosed as having LVO infarction (ICA occlusion, n = 19 [16%]; M1 occlusion, n = 26 [22%]; and M2 occlusion, n = 25 [21%]). Echocardiography showed no difference between LVO and non-LVO in terms of the ejection fraction (P = 0.64), LA dimension (P = 0.93), and LA volume (P = 0.06). However, LAVI significantly differed between the LVO and non-LVO groups (P = 0.02). Multivariate logistic regression analysis showed larger LAVI as a significant risk factor for LVO (P = 0.01). Our findings suggest that a larger LAVI is a predictor of developing LVO in patients with CCI.