{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:38:00Z","timestamp":1763642280481,"version":"3.37.3"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,9,29]],"date-time":"2017-09-29T00:00:00Z","timestamp":1506643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The clinical and echocardiographic parameters associated with the risk predictors of cryptogenic stroke (CS) in patients with patent foramen ovale (PFO) still diverse and with a great debate. We hypothesized that left atrial stiffness (LASt) and atrial dyssynchrony may increase the risk of CS in patients with PFO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 129 consecutive patients presented without clinical reasoning of stroke were recruited. Transesophageal echocardiographic assessment was performed to investigate the presence of PFO. PFO was identified in 52% (group I) and absent in 48% (group II). Utilizing speckle\u2010tracking imaging LASt and atrial dyssynchrony was evaluated among patients with PFO (group I) vs those without PFO (group II).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LASt was significantly increased in group I patients compared with group II (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a0.001). Likewise patients with PFO had a significant LA dyssynchrony compared with those in group II (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a0.001). Interatrial dyssynchrony and left atrial dyssynchrony were correlated with LASt (<jats:italic>r\u00a0<\/jats:italic>=\u00a0.47 and 0.51, respectively; <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a0.001). Cardiac arrhythmias were significantly encountered in group I patients (at presentation and with Holter monitoring) <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a0.001. Besides significantly increase in atrial dyssynchrony and in LASt in patients with arrhythmias compared with those without (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a0.001). ROC analysis revealed that LASt index\u00a0\u2265\u00a00.61 and LA dyssynchrony\u00a0\u2265\u00a023.5 predicts cardiac arrhythmias in CS patients with PFO with (AUC: 0.85 and 0.87, respectively, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, we demonstrated that LASt and atrial dyssynchrony might be risk markers of cryptogenic stroke in patients with PFO.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13721","type":"journal-article","created":{"date-parts":[[2017,9,29]],"date-time":"2017-09-29T17:02:36Z","timestamp":1506704556000},"page":"1888-1894","source":"Crossref","is-referenced-by-count":5,"title":["Atrial dyssynchrony and left atrial stiffness are risk markers for cryptogenic stroke in patients with patent foramen ovale"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4052-6440","authenticated-orcid":false,"given":"Ragab A.","family":"Mahfouz","sequence":"first","affiliation":[{"name":"Cardiology Department Zagazig University Hospital  Zagazig Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed S.","family":"Alawady","sequence":"additional","affiliation":[{"name":"Cardiology Department Zagazig University Hospital  Zagazig Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelhakem","family":"Salem","sequence":"additional","affiliation":[{"name":"Cardiology Department Zagazig University Hospital  Zagazig Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adel S.","family":"Abdelghafar","sequence":"additional","affiliation":[{"name":"Neurology Department Zagazig University Hospital  Zagazig Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,9,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2011.02.005"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.595140"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.15.1942"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.02.025"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.06.064"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.08.063"},{"key":"e_1_2_6_8_1","first-page":"565","article-title":"A classification and outline of cerebrovascular disease II","volume":"6","author":"Millikan CH","year":"1975","journal-title":"Stroke"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.recesp.2010.10.009"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01224-8"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2011.02049.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.108.813071"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.12504"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.25.4.782"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.7.1322"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.5.944"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/hs0302.104543"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2004.10.003"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2012.10.019"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fecho.13721","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.13721","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T23:59:40Z","timestamp":1696031980000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.13721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,29]]},"references-count":19,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/echo.13721"],"URL":"https:\/\/doi.org\/10.1111\/echo.13721","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"type":"print","value":"0742-2822"},{"type":"electronic","value":"1540-8175"}],"subject":[],"published":{"date-parts":[[2017,9,29]]}}}