Document Type : Review Article

Authors

1 1. Echocardiography department, Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. 2. Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan

2 1. Echocardiography department, Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Stroke is one of the primary causes of morbidity and mortality worldwide, including a large proportion of cryptogenic strokes. Long-term electrocardiographic monitoring is beneficial in detecting atrial fibrillation in patients with cryptogenic stroke in prospective studies. In this review, we aimed to evaluate the advanced echocardiographic parameters and their roles in assessing left atrial (LA) function in the incident of cryptogenic strokes and ischemic strokes. Main resources including PubMed, Scopus, and ISI Web of Science databases from 2010 until May 2021 for English published articles were evaluated. The LA echocardiographic parameters such as LA strain and strain rate, isovolumetric relaxation time (IVRT), the mean left atrial volume index (LAVI), LA reservoir volume, systole strain rate (SSR) of left atrial appendages, and lack of LA function response to maximal exercise as measured by the LA ejection fraction during rest and exercise could be considered for assessing the risk of cryptogenic strokes and/or ischemic strokes. Increased LA volumes as well as reduced LA strain rate were correlated with cryptogenic stroke. Advanced parameters of LA function, measured by speckle tracking echocardiography such as strain and strain rate values in different parts of cardiac cycle, beside standard measures of LA function such as LA ejection fraction and LAVI will define an excellent knowledge regarding LA myopathy and risk assessment of cryptogenic stroke incidence without considering traditional cardiovascular risk factors.

Keywords