{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:50:29Z","timestamp":1755795029694,"version":"3.44.0"},"reference-count":29,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"unspecified","delay-in-days":147,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Trust Foundation Dam","award":["2016\/FO82036, 2016"],"award-info":[{"award-number":["2016\/FO82036, 2016"]}]},{"DOI":"10.13039\/501100012446","name":"Akershus University Hospital","doi-asserted-by":"crossref","award":["296908"],"award-info":[{"award-number":["296908"]}],"id":[{"id":"10.13039\/501100012446","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2025,5,14]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We investigated the impact of left atrial appendage (LAA) function by LAA strain, LAA morphology and subclinical atrial fibrillation (AF) on LAA thrombus presence and thromboembolic risk conditions (TRC) in patients with cryptogenic stroke and transient ischaemic attack (TIA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>185 patients (mean age 68\u00b113 years, 33% female) were included in this prospective cohort study and underwent clinical evaluation, comprehensive transthoracic and transoesophageal echocardiography shortly after index event. LAA function and morphology were evaluated by monoplane\/multiplane\/speckle tracking strain and three-dimensional echocardiography. Combination of LAA thrombus and\/or spontaneous echo contrast (SEC) was defined as TRC. An insertable cardiac monitor was implanted in all patients to detect subclinical AF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>LAA function by novel LAA strain and LAA chicken wing were independent predictors of LAA thrombus (OR 0.9 (95% CI 0.8 to 0.95), p&lt;0.01\u2009and OR 2.5 (95% CI 1.1 to 5.8), p=0.04, respectively). LAA chicken wing and multilobate LAA were independent predictors of TRC (OR 2.3 (95% CI 1.2 to 4.5), p=0.01\u2009and OR 2.2 (95% CI 1.2 to 4.2), p=0.02, respectively).<\/jats:p>\n                  <jats:p>LAA morphology was characterised as chicken wing in 79 (43%), windsock in 64 (34%), cactus in 35 (19%), cauliflower in 7 (4%) and multilobate LAA in 115 (62%) patients. LAA thrombus was found in 29 (16%), TRC in 123 (67%) and subclinical AF in 60 (32%) patients. Duration of subclinical AF &gt;6\u2009hours was associated with SEC and recurrent stroke and TIA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>LAA function by novel LAA strain and LAA structure are independently associated with LAA thrombus and TRC in patients with cryptogenic stroke and TIA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02725944\">NCT02725944<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003287","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T23:20:24Z","timestamp":1748388024000},"page":"e003287","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Left atrial appendage function by strain and structure is associated with thromboembolic risk in patients with cryptogenic stroke and TIA"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct02725944","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02725944","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0534-1694","authenticated-orcid":false,"given":"Loreta","family":"Skrebelyte-Str\u00f8m","sequence":"first","affiliation":[{"name":"Neurolgy and Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f8rg","family":"Saberniak","sequence":"additional","affiliation":[{"name":"Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eivind","family":"Bj\u00f8rkan Orstad","sequence":"additional","affiliation":[{"name":"Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janne Elin","family":"Mykland Hilde","sequence":"additional","affiliation":[{"name":"Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole Morten","family":"R\u00f8nning","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo, Oslo, Norway"},{"name":"Neurology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4265-3598","authenticated-orcid":false,"given":"Kjetil","family":"Steine","sequence":"additional","affiliation":[{"name":"Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"2025081612073742000_12.1.e003287.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70310-7"},{"key":"2025081612073742000_12.1.e003287.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00132-5"},{"key":"2025081612073742000_12.1.e003287.3","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae150"},{"key":"2025081612073742000_12.1.e003287.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313600"},{"key":"2025081612073742000_12.1.e003287.5","first-page":"399","article-title":"Use of echocardiography to stratify the risk of 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