{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:10:53Z","timestamp":1777950653949,"version":"3.51.4"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"abstract":"Abstract<\/jats:title>\n Atrial fibrillation (AF) significantly increases the risk of ischemic stroke. This study evaluates whether transmitral atrial flow velocity (MVA), measured non-invasively via transthoracic echocardiography (TTE), predicts stroke risk in AF patients.<\/jats:p>\n To assess the independent association between TTE-derived MVA and stroke incidence in paroxysmal AF patients and its value in refining risk stratification, especially in low-risk groups.<\/jats:p>\n This cohort study included 10,150 paroxysmal AF patients from 2010 to 2021. The primary outcome was hospitalization for ischemic stroke. Multivariable Cox regression analyses adjusted for CHA2DS2-VASc scores evaluated the relationship between MVA and stroke risk.<\/jats:p>\n Over a mean follow-up of 4.26\u2009\u00b1\u20093.52 years, 2,419 (23.8%) patients developed ischemic strokes (5.59% per 100 person-years). In multivariable analysis, adjusting for CHA2DS2-VASc score, MVA was independently associated with stroke incidence. Every 10\u2009cm\/s reduction in MVA velocity conferred 4% higher stroke risk (adjusted hazard ratio [HR] 0.96 [0.94\u20130.97], P\u2009<\u20090.001). AF patients with MVA\u2009<\u200950\u2009cm\/s had a 39% increase in stroke risk compared to those with MVA \u2265 50\u2009cm\/s (adjusted HR 1.39 [1.22\u20131.58], P\u2009<\u20090.001). In patients with a CHA2DS2-VASc score of 0 or 1, the stroke incidence increased from 1.33 to 2.28% when they had MVA\u2009<\u200950\u2009cm\/s, which was similar to that of patients with a CHA2DS2-VASc score of 2 points (2.51%).<\/jats:p>\n TTE-derived MVA independently predicts stroke risk in paroxysmal AF patients. Incorporating MVA enhances risk stratification and guides targeted stroke prevention, particularly in low-risk populations.<\/jats:p>","DOI":"10.1055\/a-2760-8134","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:04:52Z","timestamp":1768608292000},"source":"Crossref","is-referenced-by-count":0,"title":["Transthoracic Transmitral Atrial Flow is Independently Associated with Ischemic Stroke Risk in Paroxysmal Atrial Fibrillation"],"prefix":"10.1055","author":[{"given":"Yi-Chih","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan, Republic of China"},{"name":"Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Ti","family":"Tsai","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan, Republic of China"},{"name":"Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1893-6360","authenticated-orcid":false,"given":"Su-Kiat","family":"Chua","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan, Republic of China"},{"name":"Division of Cardiology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pang-Shuo","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jien-Jiun","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fu-Chun","family":"Chiu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juey-Jen","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan, Republic of China"},{"name":"Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Hsien","family":"Wang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan, Republic of China"},{"name":"Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei City, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1001\/jamacardio.2018.1176","article-title":"Association of burden of atrial fibrillation with risk of ischemic stroke in adults with paroxysmal atrial fibrillation: the KP-RHYTHM study","volume":"3","author":"A S Go","year":"2018","journal-title":"JAMA Cardiol"},{"issue":"04","key":"ref2","first-page":"e29","article-title":"Heart disease and stroke statistics\u20142015 update: a report from the American 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