{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T19:28:02Z","timestamp":1772134082017,"version":"3.50.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,5,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Age\u2010related left atrial (LA) structural and functional abnormalities may be related to subclinical cerebral infarcts (SCIs) and stroke. We evaluated the association of 3\u2010dimensional echocardiographic LA contractility parameters with SCIs and stroke across the spectrum of tertiles of age increment in elderly patients with sinus rhythm, normal ejection fraction, and no history of atrial fibrillation.<\/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 enrolled 407 participants (mean age, 76\u00b18\u00a0years; 40% men) from ARIC\u2010NCS (Atherosclerosis Risk in Communities Neurocognitive Study) undergoing a brain magnetic resonance imaging and 3\u2010dimensional echocardiographic examinations in 2011 to 2013. The sample was analyzed among age tertiles and subgroups: no cerebral magnetic resonance imaging\u2013detectable infarcts (n=315), magnetic resonance imaging\u2013diagnosed SCIs (n=58), and clinically diagnosed stroke (n=34). The frequency of SCIs significantly increased over age tertiles (\n              <jats:italic>P<\/jats:italic>\n              trend 0.023). LA global longitudinal strain\u2014a 3\u2010dimensional echocardiographic index of LA reservoir function\u2014and E\/e\u2019 divided by LA global longitudinal strain\u2014an index of LA stiffness\u2014worsened across age tertiles (\n              <jats:italic>P<\/jats:italic>\n              trend 0.014 and 0.001, respectively), and only in the categories of SCIs (\n              <jats:italic>P<\/jats:italic>\n              trend &lt;0.001 and 0.045, respectively) and stroke (\n              <jats:italic>P<\/jats:italic>\n              trend 0.001 and 0.011, respectively). LA global longitudinal strain was negatively associated with increased odds of SCIs (\n              <jats:italic>P<\/jats:italic>\n              =0.036,\n              <jats:italic>P<\/jats:italic>\n              =0.008, and\n              <jats:italic>P<\/jats:italic>\n              =0.001, respectively) and strokes (\n              <jats:italic>P<\/jats:italic>\n              =0.043,\n              <jats:italic>P<\/jats:italic>\n              =0.015, and\n              <jats:italic>P<\/jats:italic>\n              =0.001, respectively) over age tertiles, with a significant interaction between age tertiles (interaction\n              <jats:italic>P<\/jats:italic>\n              =0.043 and\n              <jats:italic>P<\/jats:italic>\n              =0.010, respectively). E\/e\u2019 divided by LA global longitudinal strain was positively associated with the presence of SCIs (\n              <jats:italic>P<\/jats:italic>\n              =0.037,\n              <jats:italic>P<\/jats:italic>\n              =0.007, and\n              <jats:italic>P<\/jats:italic>\n              =0.001, respectively) and strokes (\n              <jats:italic>P<\/jats:italic>\n              =0.045,\n              <jats:italic>P<\/jats:italic>\n              =0.007, and\n              <jats:italic>P<\/jats:italic>\n              =0.003, respectively) over age tertiles, with a significant interaction only for SCIs (interaction\n              <jats:italic>P<\/jats:italic>\n              =0.040) and not for clinical stroke.\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 a large cohort study of elderly patients, among participants with sinus rhythm, normal ejection fraction, and no history of atrial fibrillation, measures of worse age\u2010related LA reservoir function and stiffness are associated with higher odds of SCIs and stroke.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024292","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T09:50:13Z","timestamp":1651485013000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Left Atrial Remodeling and Stroke in Patients With Sinus Rhythm and Normal Ejection Fraction: ARIC\u2010NCS"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9785-3402","authenticated-orcid":false,"given":"Francesco","family":"Bianco","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Brigham and Women's Hospital Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1637-574X","authenticated-orcid":false,"given":"Raffaele","family":"De Caterina","sequence":"additional","affiliation":[{"name":"Cardio\u2010Thoracic and Vascular Department, Pisa University Hospital, University of Pisa Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1753-1644","authenticated-orcid":false,"given":"Alvin","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Brigham and Women's Hospital Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iolanda","family":"Aquila","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Brigham and Women's Hospital Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4215-9218","authenticated-orcid":false,"given":"Brian","family":"Claggett","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Brigham and Women's Hospital Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0393-3589","authenticated-orcid":false,"given":"Michelle C.","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Neurology The Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Brigham and Women's Hospital Boston MA"},{"name":"University of Porto Medical School Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1975-0405","authenticated-orcid":false,"given":"Faye L.","family":"Norby","sequence":"additional","affiliation":[{"name":"Center for Cardiac Arrest Prevention, Department of Cardiology, Cedars\u2010Sinai Smidt Heart Institute, Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Cogswell","sequence":"additional","affiliation":[{"name":"Lillehei Heart Institute and Cardiovascular Division Department of Medicine University of Minnesota Minneapolis MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5632-8150","authenticated-orcid":false,"given":"Elsayed Z.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Wake Forest University Winston\u2010Salem 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