Enlarged left atrium may be associated with laterality of anterior circulation cardioembolic stroke

Abstract

Background: Propensity for lesion lateralization in atrial fibril-lation-related cardiac embolic stroke (AF-stroke) remains controversial. In this study, we compared the hemispheric differences among patients with AF-stroke and identified fac-tors associated with lesion laterality. Methods: We retrospec-tively reviewed patients with acute AF-stroke admitted from January, 2017 to March, 2022. Patients were grouped based on whether lesions were right or left hemispheric in the ante-rior circulation territory, based on diffusion-weighted imag-ing. Factors associated with right-side propensity were analyzed. Results: Among 385 patients, the mean age was 74</n>11 years and 52.5 % were male. Right and left hemi-spheric lesions were observed in 189 (49.1 %) and 196 (50.9%) patients, respectively. In the multivariate analysis, enlarged left atrium (LA) (adjusted odds ratio [aOR]=1.03, 95% confi-dential interval [CI], 1.007-1.061; p=0.013) and single conflu-ent lesion pattern (aOR= 1.55, 95% CI, 1.012-2.381; p=0.044) were associated with right hemispheric lesions. Conclusions: Enlarged LA and single confluent lesion pattern were strongly related to right-sided propensity in patients with AF-stroke.