ATRIAL CARDIOMYOPATHY AND STROKE PREVENTION - REVIEW

Abstract

Atrial cardiomyopathy (ACM) represents a novel paradigm in cardiovascular medicine, encompassing structural and functional changes within the atria that contribute to adverse clinical outcomes, notably stroke. This review explores the multifaceted implications of ACM, particularly its relevance independent of atrial fibrillation (AF) and its potential applications in stroke prevention and management. Advancements in imaging modalities, notably speckle-tracking echocardiography, offer valuable insights into atrial remodeling and dysfunction, facilitating early detection of ACM. Markers such as P-wave terminal force, NT-proBNP levels, and left atrial dimensions serve as diagnostic indicators for ACM, aiding in risk stratification in individuals devoid of AF history. Ischemic strokes are one of the most common causes of cardiovascular morbidity and mortality. A significant proportion of patients with ischemic stroke are suspected of embolic stroke without a specific embolic source being found (ESUS). The most recent related clinical trials evaluated tailored anticoagulation strategies in ACM-associated stroke, signaling a shift beyond conventional AF management. In conclusion, ACM emerges as a pivotal concept in stroke prevention, offering opportunities for personalized interventions and refined risk stratification beyond AF.

Keywords

• atrial cardiomyopathy
• atrial fibrillation
• stroke prevention
• embolic stroke of undetermined source
• la strain