{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:25:50Z","timestamp":1793381150334,"version":"4.5.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial cardiomyopathy (ACM) and cerebral small vessel disease (CSVD) share common risk factors (e.g., hypertension, diabetes, dyslipidemia, aging) and pathophysiological mechanisms (e.g., inflammatory response, oxidative stress).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the relationship between ACM and the total CSVD burden in patients with acute ischemic stroke (AIS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively enrolled eligible hospitalized AIS patients. Imaging markers were measured based on MRI data, including periventricular and deep white matter hyperintensities (WMH), enlarged perivascular spaces (EPVS), lacunes, cerebral microbleeds (CMBs), and brain atrophy. The total CSVD burden was calculated using the Wardlaw score. A P-wave terminal force in lead V1 (PTFV1)\u202f&amp;gt;\u202f5,000\u202f\u03bcV\u00b7ms was used to define atrial cardiomegaly (ACM), and a PTFV1\u202f\u2264\u202f5,000\u202f\u03bcV\u00b7ms was adopted to define non-atrial cardiomegaly (NACM). Univariate and multivariate ordinal logistic regression analyses estimated the correlation between ACM and total CSVD burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 323 enrolled patients (mean age 67.67\u202fyears, 63.7% male), 83 were classified as ACM. Patients with ACM had significantly higher total Wardlaw scores (OR\u202f=\u202f1.79, 95% CI\u202f=\u202f1.07\u20133.02,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.026). Age, hypertension, and NIHSS score were also independent risk factors for increased total burden [OR\u202f=\u202f1.05 (95% CI\u202f=\u202f1.02\u20131.07,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), 2.09 (95% CI\u202f=\u202f1.29\u20133.42,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.003), and 1.13 (95% CI\u202f=\u202f1.03\u20131.24,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.009), respectively].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study found a suggestive association between ACM and total CSVD burden in AIS patients, underscoring the importance of assessing ACM for evaluating CSVD risk factors in this patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1668267","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T05:26:50Z","timestamp":1769750810000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Correlation between atrial cardiomyopathy and total burden of cerebral small vessel disease in patients with acute ischemic stroke"],"prefix":"10.3389","volume":"17","author":[{"given":"Qing","family":"He","sequence":"first","affiliation":[{"name":"The First School of Clinical Medicine, Shaanxi University of Chinese Medicine","place":["Xianyang, China"]},{"name":"Department of Encephalopathy, Xi'an TCM Hospital of Encephalopathy","place":["Xi'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Graduate School, China Academy of Chinese Medical Sciences","place":["Beijing, China"]},{"name":"Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine","place":["Xianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiru","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Second Affiliated Hospital of Shaanxi University of Chinese Medicine","place":["Xianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjun","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine","place":["Xianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Affiliated Hospital of Shaanxi University of Chinese Medicine","place":["Xianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Affiliated Hospital of Shaanxi University of Chinese Medicine","place":["Xianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichao","family":"Ma","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine, Shaanxi University of Chinese Medicine","place":["Xianyang, China"]},{"name":"Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine","place":["Xianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1093\/europace\/euw161","article-title":"EHRA\/HRS\/APHRS\/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication","volume":"18","author":"Goette","year":"2016","journal-title":"Europace"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e015343","DOI":"10.1161\/JAHA.119.015343","article-title":"Characterization, Pathogenesis, and Clinical Implications of Inflammation-Related Atrial Myopathy as an Important Cause of Atrial Fibrillation","volume":"9","author":"Packer","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2417","DOI":"10.1016\/j.jcmg.2019.02.021","article-title":"Left atrial mechanical function and incident ischemic cerebrovascular events independent of AF: insights from the MESA study","volume":"12","author":"Habibi","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1016\/j.jacc.2017.06.033","article-title":"Atrial cardiomyopathy: a useful notion in cardiac disease management or a passing fad","volume":"70","author":"Guichard","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s10840-022-01243-8","article-title":"Left atrial echocardiographic parameters predict the onset of atrial fibrillation: the SMASH2 scoring system","volume":"65","author":"Darlington","year":"2022","journal-title":"J Interv Card Electrophysiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1711","DOI":"10.1177\/0963689718795148","article-title":"Cerebral Small Vessel Disease","volume":"27","author":"Li","year":"2018","journal-title":"Cell Transplant"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1177\/17474930221144911","article-title":"Cerebral small vessel disease: Recent advances and future directions","volume":"18","author":"Markus","year":"2023","journal-title":"Int J Stroke"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1159\/000533678","article-title":"Prevalence and Risk Factors of Cerebral Small Vessel Disease from a Population-Based Cohort in China","volume":"57","author":"Yang","year":"2023","journal-title":"Neuroepidemiology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s00395-024-01038-0","article-title":"Pathophysiology and clinical relevance of atrial myopathy","volume":"119","author":"Tubeeckx","year":"2024","journal-title":"Basic Res Cardiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1050","DOI":"10.1007\/s12975-023-01195-9","article-title":"Cerebral small vessel disease: a review of the pathophysiological mechanisms","volume":"15","author":"Hannawi","year":"2024","journal-title":"Transl Stroke Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"102247","DOI":"10.1016\/j.arr.2024.102247","article-title":"Blood-based biomarkers of cerebral small vessel disease","volume":"95","author":"Wu","year":"2024","journal-title":"Ageing Res Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1161\/CIRCRESAHA.116.308446","article-title":"Heart-Brain Axis: Effects of Neurologic Injury on Cardiovascular Function","volume":"120","author":"Tahsili-Fahadan","year":"2017","journal-title":"Circ Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e288","DOI":"10.1212\/WNL.0000000000006748","article-title":"Atrial cardiopathy in patients with embolic strokes of unknown source and other stroke etiologies","volume":"92","author":"Jalini","year":"2019","journal-title":"Neurology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2428","DOI":"10.1016\/j.jcmg.2019.02.008","article-title":"Does left atrial mechanical dysfunction contribute to a thrombogenic atrial myopathy","volume":"12","author":"Kamel","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"25124","DOI":"10.31083\/RCM25124","article-title":"Atrial Cardiomyopathy: From Diagnosis to Treatment","volume":"26","author":"Liu","year":"2025","journal-title":"Rev Cardiovasc Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"4055","DOI":"10.1002\/ehf2.13488","article-title":"Abnormal P-wave terminal force in lead V1 is a marker for atrial electrical dysfunction but not structural remodelling","volume":"8","author":"Lebek","year":"2021","journal-title":"ESC Heart Fail"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.jelectrocard.2021.06.011","article-title":"Abnormal P-wave terminal force in lead V1 is associated with low left atrial appendage ejection velocity","volume":"67","author":"McConkey","year":"2021","journal-title":"J Electrocardiol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"3208","DOI":"10.1161\/STROKEAHA.115.009989","article-title":"Electrocardiographic left atrial abnormality and risk of stroke: Northern Manhattan study","volume":"46","author":"Kamel","year":"2015","journal-title":"Stroke"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1161\/STROKEAHA.114.007762","article-title":"Association between left atrial abnormality on ECG and vascular brain injury on MRI in the Cardiovascular Health Study","volume":"46","author":"Kamel","year":"2015","journal-title":"Stroke"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1002\/ana.24482","article-title":"Electrocardiographic left atrial abnormality and stroke subtype in the atherosclerosis risk in communities study","volume":"78","author":"Kamel","year":"2015","journal-title":"Ann Neurol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e0203774","DOI":"10.1371\/journal.pone.0203774","article-title":"Electrocardiographic left atrial abnormality and silent vascular brain injury: the Northern Manhattan Study","volume":"13","author":"Hunter","year":"2018","journal-title":"PLoS One"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1001\/jama.2020.26867","article-title":"Diagnosis and management of transient ischemic attack and acute ischemic stroke: a review","volume":"325","author":"Mendelson","year":"2021","journal-title":"JAMA"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1016\/S1474-4422(13)70124-8","article-title":"Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration","volume":"12","author":"Wardlaw","year":"2013","journal-title":"Lancet Neurol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1212\/wnl.43.9.1683","article-title":"Pathologic correlates of incidental MRI white matter signal hyperintensities","volume":"43","author":"Fazekas","year":"1993","journal-title":"Neurology"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1212\/WNL.0000000000000837","article-title":"Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden","volume":"83","author":"Staals","year":"2014","journal-title":"Neurology"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1212\/01.wnl.0000101463.50798.0d","article-title":"Cerebral microbleeds are regionally associated with intracerebral hemorrhage","volume":"62","author":"Lee","year":"2004","journal-title":"Neurology"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2267","DOI":"10.1212\/wnl.44.12.2267","article-title":"A method to improve interrater reliability of visual inspection of brain MRI scans in dementia","volume":"44","author":"Victoroff","year":"1994","journal-title":"Neurology"},{"key":"ref28","first-page":"45","article-title":"Study of formula for calculating body surface areas of the Chinese adults","volume":"51","author":"Hu","year":"1999","journal-title":"Sheng Li Xue Bao"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12974-022-02468-0","article-title":"Association of inflammatory markers with cerebral small vessel disease in community-based population","volume":"19","author":"Jiang","year":"2022","journal-title":"J Neuroinflammation"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1161\/STROKEAHA.124.049826","article-title":"Does the Burden of CSVD Modify the Efficacy of Dual Antiplatelet Therapy?: A Post Hoc Analysis of the INSPIRES Trial","volume":"56","author":"Li","year":"2025","journal-title":"Stroke"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1177\/1747493015607517","article-title":"Leukoaraiosis and lacunes are associated with poor clinical outcomes in ischemic stroke patients treated with intravenous thrombolysis","volume":"11","author":"Arba","year":"2016","journal-title":"Int J Stroke"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1161\/STROKEAHA.117.017429","article-title":"Association of White Matter Hyperintensities With Short-Term Outcomes in Patients With Minor Cerebrovascular Events","volume":"49","author":"Zerna","year":"2018","journal-title":"Stroke"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"150","DOI":"10.2174\/157340310791658730","article-title":"Cardioembolic stroke: clinical features, specific cardiac disorders and prognosis","volume":"6","author":"Arboix","year":"2010","journal-title":"Curr Cardiol Rev"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1136\/svn-2023-002447","article-title":"Distribution of atrial cardiomyopathy markers and association with atrial fibrillation detected after ischaemic stroke in the SAFAS study","volume":"9","author":"Didier","year":"2024","journal-title":"Stroke Vasc Neurol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"15","DOI":"10.3390\/brainsci15080813","article-title":"Prevalent Cardiovascular Disease and Atrial Fibrillation in Relation to Cerebral Small Vessel Disease Burden","volume":"15","author":"Ekenze","year":"2025","journal-title":"Brain Sci"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1668267\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T05:26:54Z","timestamp":1769750814000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1668267\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":35,"alternative-id":["10.3389\/fneur.2026.1668267"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1668267","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]},"article-number":"1668267"}}