{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T09:19:24Z","timestamp":1787995164673,"version":"build-2784847793"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Stroke is a major comorbidity in patients with heart failure (HF), especially in those with decreased left atrial (LA) function, and thus, identifying patients highly at risk of stroke can prevent its occurrence. We evaluated the predictive value of global longitudinal strain of LA (LAGLS) in patients with acute HF and sinus rhythm.<\/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              In this retrospective study, 2461 patients (53.3% men, 69.7\u00b114.4\u00a0years old) with sinus rhythm and LAGLS among 4312 consecutive patients with acute HF from 3 tertiary hospitals were included. HF phenotypes were defined as HF with reduced ejection fraction (EF) (left ventricular EF \u226440%), HF with midrange EF (40% &lt;left ventricular EF &lt;50%), and HF with preserved ejection fraction (left ventricular EF \u226550%). Primary outcome was new\u2010onset stroke. The mean left ventricular EF was 39.4%\u00b115.6%. Moreover, 1388 (57.5%), 342 (14.2%), and 682 (28.3%) were classified with HF with reduced EF, HF with midrange EF, and HF with preserved EF, retrospectively. LAGLS was 17.2%\u00b110.4%. During the follow\u2010up duration (mean: 30.3\u00b125.4\u00a0months), 100 patients experienced stroke. Patients with stroke had higher LA diameter (\n              <jats:italic>P<\/jats:italic>\n              =0.031) and lower LAGLS (\n              <jats:italic>P<\/jats:italic>\n              =0.010) than those without stroke. In the univariate analysis, age, diabetes mellitus, LA diameter, LA volume index, and LAGLS were significant risk factors for stroke. In the multivariate analysis, each 1% decrease in LAGLS was associated with a 3.8% increased risk for stroke (hazard ratio [HR], 1.038; 95% CI, 1.013\u20131.065;\n              <jats:italic>P<\/jats:italic>\n              =0.003). When applying a LAGLS cutoff point of 14.5%, patients with LAGLS &lt;14.5% had approximately twice the risk for stroke after adjusting other significant variables (HR, 1.940; 95% CI, 1.269\u20132.965;\n              <jats:italic>P<\/jats:italic>\n              =0.002).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In patients with acute HF and sinus rhythm, decreased LAGLS (&lt;14.5%) was associated with an increased risk for stroke, with an annual incidence of 2.38%.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020414","type":"journal-article","created":{"date-parts":[[2021,6,30]],"date-time":"2021-06-30T08:58:31Z","timestamp":1625043511000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Left Atrial Strain to Predict Stroke in Patients With Acute Heart Failure and Sinus Rhythm"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7035-286X","authenticated-orcid":false,"given":"Jae\u2010Hyeong","family":"Park","sequence":"first","affiliation":[{"name":"Department of Cardiology in Internal Medicine Chungnam National University HospitalChungnam National University College of Medicine Daejeon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4966-3924","authenticated-orcid":false,"given":"In\u2010Chang","family":"Hwang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center &amp; Department of Internal Medicine Seoul National University College of MedicineSeoul National University Bundang Hospital Seongnam Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9611-1490","authenticated-orcid":false,"given":"Jin Joo","family":"Park","sequence":"additional","affiliation":[{"name":"Cardiovascular Center &amp; Department of Internal Medicine Seoul National University College of MedicineSeoul National University Bundang Hospital Seongnam Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4053-8713","authenticated-orcid":false,"given":"Jun\u2010Bean","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University College of MedicineSeoul National University Hospital Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7067-5535","authenticated-orcid":false,"given":"Goo\u2010Yeong","family":"Cho","sequence":"additional","affiliation":[{"name":"Cardiovascular Center &amp; Department of Internal Medicine Seoul National University College of MedicineSeoul National University Bundang Hospital Seongnam Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000757"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)30073-4"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.114.003057"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.8.1049"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.628479"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.2.288"},{"key":"e_1_3_1_8_2","first-page":"1424","article-title":"Does heart failure confer a hypercoagulable state? 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