The Cardiovascular Abnormalities and Brain Lesions study aimed to investigate the association between left atrial strain (LAε) and left atrial strain rate (LASR) with ischemic stroke in older adults. The study was conducted from 2005 to 2010 and included 806 participants aged 55 years or older without prior history of stroke or atrial fibrillation. Annual follow-up telephone interviews were completed in 2022 and statistical analysis was performed from June to November of the same year. LAε and LASR were assessed using speckle-tracking echocardiography, and the association with ischemic stroke was assessed using cause-specific Cox proportional hazards regression modeling. The study found that reduced positive longitudinal LAε and positive longitudinal LASR were independently associated with ischemic stroke in older adults, even among participants with normal LA size. This suggests that assessment of LAε and LASR may improve stroke risk stratification in elderly individuals. The study population consisted of 62.2% women, with a mean age of 71.0 years and 14.8% were Black, 70.3% were Hispanic, and 13.0% were White. During a mean follow-up of 10.9 years, 6.6% of the participants developed new-onset ischemic stroke, and 12.8% had incident atrial fibrillation. These findings suggest the importance of considering LAε and LASR in stroke risk stratification in older adults, particularly in those with normal LA size.
doi:10.1001/jamacardio.2022.5449
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