{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:47:21Z","timestamp":1780649241845,"version":"3.54.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,4,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Ischemic stroke in young individuals often remains cryptogenic. Some of these strokes likely originate from the heart, and atrial fibrosis might be one of the etiological mechanisms. In this pilot study, we investigated whether advanced echocardiography findings of the left atrium (\n              <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>\n              ) of young cryptogenic stroke patients differ from those of stroke\u2010free controls.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We recruited 30 cryptogenic ischemic stroke patients aged 18 to 49 years and 30 age\u2010 and sex\u2010matched stroke\u2010free controls among participants of the\n              <jats:styled-content style=\"fixed-case\">SECRETO<\/jats:styled-content>\n              (Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome) study (\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              01934725). We measured basic left ventricular parameters and detailed measures of the\n              <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>\n              , including 4\u2010dimensional volumetry, speckle tracking epsilon, strain rate, and\n              <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>\n              appendix orifice variation. Data were compared as continuous parameters and by tertiles. Compared with controls, stroke patients had smaller\n              <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>\n              reservoir volumes (10.2 [interquartile range, 5.4] versus 13.2 [5.4]\n              <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>\n              ;\n              <jats:italic>P<\/jats:italic>\n              =0.030) and smaller positive epsilon values (17.8 [8.5] versus 20.8 [10.1];\n              <jats:italic>P<\/jats:italic>\n              =0.023). In the tertile analysis, stroke patients had significantly lower left atrial appendage orifice variation (3.88 [0.75] versus 4.35 [0.90] mm;\n              <jats:italic>P<\/jats:italic>\n              =0.043), lower\n              <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>\n              cyclic volume change (9.2 [2.8] versus 12.8 [3.5]\n              <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>\n              ;\n              <jats:italic>P<\/jats:italic>\n              =0.023), and lower\n              <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>\n              contraction peak strain rate (\u22121.8 [0.6] versus \u22122.3 [0.6];\n              <jats:italic>P<\/jats:italic>\n              =0.021). We found no statistically significant differences in left ventricular measures.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This preliminary comparison suggests altered\n              <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>\n              dynamics in young patients with cryptogenic ischemic stroke, and thus that\n              <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>\n              wall pathology might contribute to these strokes. Our results await confirmation in a larger sample.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.014578","type":"journal-article","created":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T09:00:51Z","timestamp":1585126851000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Left Atrial Dynamics Is Altered in Young Adults With Cryptogenic Ischemic Stroke: A Case\u2010Control Study Utilizing Advanced Echocardiography"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4030-9358","authenticated-orcid":false,"given":"Jani","family":"Pirinen","sequence":"first","affiliation":[{"name":"HUS Medical Imaging Center Clinical Physiology and Nuclear Medicine University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vesa","family":"J\u00e4rvinen","sequence":"additional","affiliation":[{"name":"HUS Medical Imaging Center Clinical Physiology and Nuclear Medicine University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Martinez\u2010Majander","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Sinisalo","sequence":"additional","affiliation":[{"name":"Heart and Lung Center Helsinki University Hospital and Helsinki University Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauli","family":"P\u00f6yh\u00f6nen","sequence":"additional","affiliation":[{"name":"Heart and Lung Center Helsinki University Hospital and Helsinki University Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukka","family":"Putaala","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20617"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.662866"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70310-7"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.0591"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000158908.48022.d7"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.08.015"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.595140"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006748"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.12.036"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.012004"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/NRL.0000000000000182"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/2396987317703210"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1530\/ERP-19-0025"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew082"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90298-4"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.11.006"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey042"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/echo.14261"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198710223171717"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.04.004"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jep054"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey018"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.019641"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-015-0800-1"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.901831"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.03.557"},{"key":"e_1_3_2_28_2","first-page":"790","article-title":"The correlation between the mouth diameter of left atrial appendage and stroke risk score in patients with atrial fibrillation","volume":"19","author":"Tang B","year":"2015","unstructured":"Tang B, Zhang H, Jiang L. The correlation between the mouth diameter of left atrial appendage and stroke risk score in patients with atrial fibrillation. Eur Rev Med Pharmacol Sci. 2015;19:790\u2013794.","journal-title":"Eur Rev Med Pharmacol Sci"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.014578","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:25:18Z","timestamp":1715599518000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.014578"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,9]]},"references-count":27,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,4,9]]}},"alternative-id":["10.1161\/JAHA.119.014578"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.014578","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,9]]},"assertion":[{"value":"2020-09-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e014578"}}