{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:53:52Z","timestamp":1786323232584,"version":"build-2736575974"},"reference-count":26,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2014,3,13]],"date-time":"2014-03-13T00:00:00Z","timestamp":1394668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","award":["24591084"],"award-info":[{"award-number":["24591084"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Atrial fibrillation impairs left atrial appendage function and the thrombus formation in the left atrial appendage is a major cause of cardioembolic stroke. <\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p> To evaluate the association between the volume of the left atrial appendage measured by real-time three-dimensional transesophageal echocardiography and presence of paroxysmal atrial fibrillation in patients with cerebral infarction or transient ischemic attack. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Real-time three-dimensional transesophageal echocardiography was performed to measure left atrial appendage end-diastolic and end-systolic volumes to calculate left atrial appendage ejection fraction. Patients with normal sinus rhythm at the time of real-time three-dimensional transesophageal echocardiography were divided into groups with and without paroxysmal atrial fibrillation. Volumetric data were corrected with the body surface area. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Of 146 patients registered, 102 (29 women, 72\u00b72 \u00b1 10\u00b77 years) were normal sinus rhythm at the examination. In 23 patients with paroxysmal atrial fibrillation, left atrial appendage end-diastolic volume (4\u00b778 \u00b1 3\u00b700 ml\/m<jats:sup>2<\/jats:sup> vs. 3\u00b714 \u00b1 2\u00b704 ml\/m<jats:sup>2<\/jats:sup>, P = 0\u00b7003) and end-systolic volume (3\u00b710 \u00b1 2\u00b747 ml\/m<jats:sup>2<\/jats:sup> vs. 1\u00b739 \u00b1 1\u00b756 ml\/m<jats:sup>2<\/jats:sup>, P &lt; 0\u00b7001) were larger and left atrial appendage ejection fraction (37\u00b73 \u00b119\u00b71% vs. 57\u00b71 \u00b1 17\u00b75%, P &lt; 0\u00b7001) was lower than in the other 79 patients without paroxysmal atrial fibrillation. The optimal cutoff for left atrial appendage peak flow velocity to predict paroxysmal atrial fibrillation was 39\u00b70 cm\/s (sensitivity, 54\u00b76%; specificity, 89\u00b77%; c-statistic, 0\u00b7762). The cutoffs for left atrial appendage end-diastolic volume, end-systolic volume, and ejection fraction were 4\u00b752 ml\/m<jats:sup>2<\/jats:sup> (sensitivity, 47\u00b78%; specificity, 82\u00b73%; c-statistic, 0\u00b7694), 1\u00b726 ml\/m<jats:sup>2<\/jats:sup> (sensitivity, 91\u00b73%; specificity, 60\u00b73%; c-statistic, 0\u00b7806), and 47\u00b79% (sensitivity, 78\u00b73%; specificity, 74\u00b77%; c-statistic, 0\u00b7774), respectively. In multivariate analysis, all these parameters were independently associated with paroxysmal atrial fibrillation after adjusting for sex, age, diabetes mellitus, and previous stroke. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Left atrial appendage volumetric analysis by real-time three-dimensional transesophageal echocardiography is a promising method for detecting paroxysmal atrial fibrillation in acute cerebral infarction or transient ischemic attack. <\/jats:p><\/jats:sec>","DOI":"10.1111\/ijs.12268","type":"journal-article","created":{"date-parts":[[2014,3,13]],"date-time":"2014-03-13T04:38:42Z","timestamp":1394685522000},"page":"1045-1051","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Three-Dimensional Analysis of the Left Atrial Appendage for Detecting Paroxysmal Atrial Fibrillation in Acute Ischemic Stroke"],"prefix":"10.1177","volume":"9","author":[{"given":"Koji","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Koga","sequence":"additional","affiliation":[{"name":"Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuaki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rieko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Minematsu","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunori","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, 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