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Letter to the Editor
Echocardiographic parameters of atrial cardiopathy and the detection of atrial fibrillation in patients with cryptogenic stroke
Parámetros ecocardiográficos de cardiopatía auricular y detección de fibrilación auricular en el ictus criptogénico
Á. Lambea Gila,
Corresponding author
alvarolambea@gmail.com

Corresponding author.
, H. Tejada Mezab,c, C.R. López Peralesd, J. Artal Royb, J. Marta Morenob
a Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, Spain
b Unidad de Ictus, Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, Spain
c Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Spain
d Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain
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increases the risk of stroke&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Given their short duration and the fact that they are often asymptomatic and may not co-occur with neurological symptoms&#44; these episodes are classified under stroke of undetermined cause&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">3&#44;5</span></a> The heterogeneity of this group&#44; combined with the limited use of prolonged cardiac monitoring &#40;whether due to patient intolerance or to the unavailability of monitoring equipment and differences between devices&#41;&#44; has led researchers to investigate parameters correlated with greater incidence of AF&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a> with a view to increasing the utility of the technique&#46; These parameters include electrocardiographic&#44; biochemical&#44; and echocardiographic variables&#44; which have been found to be associated not only with AF but also with ischaemic stroke and recurrent stroke&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">1&#44;7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We present the case of a patient with acute ischaemic stroke and morphological and functional signs of left atrial cardiopathy in an echocardiography study&#59; these findings were correlated with paroxysmal AF&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was a functionally independent 77-year-old woman who came to the emergency department due to right hemiparesis and mixed aphasia&#46; She scored 1 on the NIHSS due to language impairment&#44; which resolved completely 3<span class="elsevierStyleHsp" style=""></span>hours after symptom onset&#46; A baseline head CT scan revealed no signs of haemorrhage or acute ischaemia&#59; the patient scored 7 on the ABCD2 scale&#44; and was admitted to the stroke unit for cardiac monitoring&#46; She remained asymptomatic for 18<span class="elsevierStyleHsp" style=""></span>hours&#44; after which she presented an episode of isolated mixed aphasia &#40;NIHSS&#58; 4&#41;&#46; No changes were observed in CT images&#46; Intravenous fibrinolysis achieved progressive recovery&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Our patient presented hypertension&#44; dyslipidaemia&#44; and type 2 diabetes mellitus&#59; treatment adherence was good and blood analysis results were within normal ranges&#46; In 2012&#44; she underwent implantation of a DDDR pacemaker due to complete atrioventricular block associated with sinus dysfunction&#46; An echocardiography performed in 2016 revealed mild left ventricular hypertrophy and mitral valve regurgitation&#44; with no alterations in atrial morphology or other signs of structural heart disease&#46; In view of the 2 episodes of sudden-onset focal neurological signs &#40;with one episode characterised by isolated aphasia&#41;&#44; we requested the pacemaker records from the cardiology department&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The patient continued under observation while we awaited the pacemaker records&#46; Twenty-four-hour Holter monitoring revealed sinus rhythm and no arrhythmia&#59; the patient was therefore transferred to the neurology ward&#46; A Doppler ultrasound of the supra-aortic trunks revealed atheromatous plaques in the carotid territory bilaterally&#44; without haemodynamic impairment&#59; transcranial Doppler ultrasound did not detect stenosis&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the findings from transthoracic echocardiography&#44; adjusted for body surface area &#40;1&#46;657<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&#46; Atrial diameter and area were compatible with mild left atrial enlargement&#44; whereas volume and such functional activity parameters as left atrial ejection fraction &#40;LAEF&#41; and left atrial strain &#40;LAS&#41; indicated more severe dysfunction of the cardiac chamber &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The pacemaker data revealed an episode of paroxysmal AF lasting 17<span class="elsevierStyleHsp" style=""></span>hours&#44; which occurred 3 months previously&#44; and another episode occurring 4 days after the cerebrovascular event&#59; the patient presented sinus rhythm during neurological symptoms&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The patient was asymptomatic at discharge and was diagnosed with ischaemic stroke of cardioembolic origin secondary to paroxysmal AF&#46; She started treatment with oral anticoagulants&#59; her functional status at 3 months was similar to that before hospital admission &#40;mRS&#58; 1&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">We were presented with the case of a patient with no signs of significant intra- or extracranial atherosclerosis&#44; displaying sinus rhythm during 24-hour Holter monitoring&#46; In view of the strong association between isolated aphasia and cardioembolic arrhythmia&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a> we performed a comprehensive transthoracic echocardiography study to evaluate parameters that may support prolonged cardiac monitoring&#44; in case the pacemaker records showed no relevant data&#44; considering the potential for episodes of AF not to co-occur with stroke onset&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The echocardiographic parameters most frequently used in our hospital to characterise the left atrium are area and anteroposterior diameter&#59; whenever possible&#44; these are adjusted for body surface area to avoid sex-related variability&#46; However&#44; these parameters tend to underestimate the true size of the atrium &#40;as compared to volumetry&#41; since linear measurements do not reflect differences in deformation on different planes&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a> Left atrial volume is more accurate but has the limitation that it is difficult to measure&#46; Technical advances have made it easier to calculate&#44; making this the morphological parameter of choice in clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">8&#44;9</span></a> Another potentially useful structural parameter is the analysis of left atrial appendage morphology with transoesophageal echocardiography&#44; due to the potential association between certain morphological patterns and increased risk of thromboembolism&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Left atrial function parameters are less frequently used&#44; although they are also reported to be correlated with increased risk of AF and ischaemic stroke regardless of the morphology of this chamber&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">10&#44;11</span></a> Even in patients with normal left atria&#44; this association represents a shift from the traditional classification of atrial damage based exclusively on chamber enlargement&#46; Two useful left atrial function parameters are LAEF and LAS&#46; The latter measures myocardial deformation using speckle tracking echocardiography&#59; this technique analyses atrial contractility&#44; which has been found to be associated with structural degeneration&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Based on the data shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> and the considerations discussed with regard to different echocardiographic parameters&#44; the transthoracic echocardiography study typically performed at our hospital &#40;with the left atrium assessed by measuring anteroposterior diameter and area&#41; would only have shown mild left atrial enlargement&#59; however&#44; volumetric data indicated severe atrial enlargement &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; This finding&#44; which would have gone unnoticed had we not gathered volumetric data&#44; points to an association between left atrial enlargement and both higher incidence of AF and recurrent stroke&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">14</span></a> An LAEF below 50&#37; and an LAS below 25&#46;8&#37; in the reservoir phase also point to underlying paroxysmal AF&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">10&#44;11</span></a></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The aetiological study of stroke includes echocardiographic parameters and other biochemical and electrocardiographic markers &#40;proBNP levels&#44; P terminal force in the V1 lead&#44; etc&#41; to identify probable emboligenic arrhythmia&#59; the inclusion of these parameters is based on the traditional idea of AF as a cause of cardiac remodelling&#44; venous stasis&#44; and subsequent thromboembolism&#46; However&#44; research into the association between these parameters and AF incidence suggests that many of them correlate directly with the incidence and recurrence of ischaemic stroke&#44; regardless of whether the patient has AF&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">1&#44;7</span></a> Consequently&#44; the pathophysiology of cardioembolic stroke is thought to be more complex&#58; the idea of atrial cardiopathy as a dysfunction capable in itself of increasing the risk of embolism is becoming more widespread&#59; AF is still considered the cause&#44; aggravating factor&#44; or consequence&#44; depending on the case&#44; but is no longer regarded as a necessary condition for cardioembolic stroke&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">1&#44;7&#44;15</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">However&#44; regardless of these new hypotheses about the pathophysiology of thrombus formation&#44; AF continues to be a major source of cardioembolism&#59; detection of AF is closely related to the type and duration of cardiac monitoring to be performed&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a> The case presented constitutes a good example of the usefulness of certain echocardiographic parameters due to their association with higher incidence of underlying AF&#46; Furthermore&#44; in our patient these parameters were the only factors associated with emboligenic arrhythmia&#59; this is particularly interesting considering the increasing importance of focused cardiac ultrasound in neurology training&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In conclusion&#44; different tools may be used to determine whether ischaemic stroke of undetermined aetiology is due to emboligenic factors&#46; When the most frequent emboligenic causes are ruled out&#44; left atrial volumetry or assessment of left atrial function &#40;LAEF and LAS&#41; may help us to determine whether patients are eligible for prolonged cardiac monitoring to screen for AF with a view to choosing the most suitable treatment&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Lambea Gil &#193;&#44; Tejada Meza H&#44; L&#243;pez Perales CR&#44; Artal Roy J&#44; Marta Moreno J&#46; Par&#225;metros ecocardiogr&#225;ficos de cardiopat&#237;a auricular y detecci&#243;n de fibrilaci&#243;n auricular en el ictus criptog&#233;nico&#46; Neurolog&#237;a&#46; 2020&#59;35&#58;284&#8211;287&#46;</p>"
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        "etiqueta" => "Figure 1"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Two-dimensional transthoracic echocardiography&#59; apical 4-chamber view&#46; Measurement of left atrial volume with the biplane Simpson method &#40;A&#41; and longitudinal left atrial strain with speckle tracking echocardiography &#40;B&#41;&#46;</p>"
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      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
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          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A4C&#58; apical 4-chamber&#59; AP&#58; anteroposterior&#59; LAEF&#58; left atrial ejection fraction&#59; LAS&#58; left atrial strain&#59; LLN&#58; lower limit of normal&#59; ULN&#58; upper limit of normal&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Our patient&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Normal results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AP diameter &#40;mm&#41;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LLN 38&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Area in A4C view &#40;cm<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LLN 20&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AP diameter&#44; indexed &#40;mm&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LLN 23&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Area in A4C view&#44; indexed &#40;cm<span class="elsevierStyleSup">2</span>&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">15&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">LLN 11&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Volume in A4C view&#44; indexed &#40;mL&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">57&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">LLN 34&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">LAEF &#40;&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">35&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">ULN 50&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">LAS in reservoir phase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">20&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">ULN 25&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiography findings&#58; left atrium morphological and functional parameters&#44; adjusted for body surface area and sex&#46;</p>"
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          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A4C&#58; apical 4-chamber&#59; AP&#58; anteroposterior&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mild enlargement&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Moderate enlargement&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Severe enlargement&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">AP diameter &#40;mm&#41;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Area in A4C view &#40;cm<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Volume in A4C view&#44; indexed &#40;mL&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Left atrial morphology data obtained with transthoracic echocardiography and classification by severity&#46;</p>"
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        0 => array:2 [
          "identificador" => "bibs0015"
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            0 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardioembolic stroke"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46; Kamel"
                            1 => "J&#46; Healey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Circ Res"
                        "fecha" => "2017"
                        "volumen" => "120"
                        "paginaInicial" => "514"
                        "paginaFinal" => "526"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0085"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Embolic strokes of undetermined source&#58; the case for a new clinical construct"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;G&#46; Hart"
                            1 => "H&#46;C&#46; Diener"
                            2 => "S&#46;B&#46; Coutts"
                            3 => "J&#46;D&#46; Easton"
                            4 => "C&#46;B&#46; Granger"
                            5 => "M&#46;J&#46; O&#8217;Donnell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1474-4422(13)70310-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Neurol"
                        "fecha" => "2014"
                        "volumen" => "13"
                        "paginaInicial" => "429"
                        "paginaFinal" => "438"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24646875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subclinical auricular fibrillation and the risk of stroke"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;S&#46; Healey"
                            1 => "S&#46;J&#46; Connolly"
                            2 => "M&#46;R&#46; Gold"
                            3 => "C&#46;W&#46; Israel"
                            4 => "I&#46;C&#46; van Gelder"
                            5 => "A&#46; Capucci"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1105575"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2012"
                        "volumen" => "366"
                        "paginaInicial" => "120"
                        "paginaFinal" => "129"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22236222"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship between daily auricular tachyarrhythmia burden from implantable device diagnostics and stroke risk&#58; the TRENDS study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;V&#46; Glotzer"
                            1 => "E&#46;G&#46; Daoud"
                            2 => "D&#46;G&#46; Wyse"
                            3 => "D&#46;E&#46; Singer"
                            4 => "M&#46;D&#46; Ezekowitz"
                            5 => "C&#46; Hilker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCEP.109.849638"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ Arrhythm Electrophysiol"
                        "fecha" => "2009"
                        "volumen" => "2"
                        "paginaInicial" => "474"
                        "paginaFinal" => "480"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19843914"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Temporal relationship between subclinical auricular fibrillation and embolic events"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Brambatti"
                            1 => "S&#46;J&#46; Connolly"
                            2 => "M&#46;R&#46; Gold"
                            3 => "C&#46;A&#46; Morillo"
                            4 => "A&#46; Capucci"
                            5 => "C&#46; Muto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.113.007825"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2014"
                        "volumen" => "129"
                        "paginaInicial" => "2094"
                        "paginaFinal" => "2099"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24633881"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atrial fibrillation and mechanisms of stroke"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Kamel"
                            1 => "P&#46;M&#46; Okin"
                            2 => "M&#46;S&#46; Elkind"
                            3 => "C&#46; Iadecola"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2016"
                        "volumen" => "47"
                        "paginaInicial" => "895"
                        "paginaFinal" => "900"
                      ]
                    ]
                  ]
                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Atrial cardiopathy&#58; a broadened concept of left auricular thromboembolism beyond auricular fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Kamel"
                            1 => "P&#46;M&#46; Okin"
                            2 => "W&#46;T&#46; Longstreth"
                            3 => "M&#46;S&#46; Elkind"
                            4 => "E&#46;Z&#46; Soliman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Future Cardiol"
                        "fecha" => "2015"
                        "volumen" => "11"
                        "paginaInicial" => "323"
                        "paginaFinal" => "331"
                      ]
                    ]
                  ]
                ]
              ]
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            7 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for cardiac chamber quantification by echocardiography in adults&#58; an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Lang"
                            1 => "L&#46;P&#46; Badano"
                            2 => "V&#46; Mor-Avi"
                            3 => "J&#46; Afilalo"
                            4 => "A&#46; Armstrong"
                            5 => "L&#46; Ernande"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2015"
                        "volumen" => "28"
                        "paginaInicial" => "e14"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for chamber quantification"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Lang"
                            1 => "M&#46; Bierig"
                            2 => "R&#46;B&#46; Devereux"
                            3 => "F&#46;A&#46; Flachskampf"
                            4 => "E&#46; Foster"
                            5 => "P&#46;A&#46; Pellikka"
                          ]
                        ]
                      ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.euje.2005.12.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Echocardiogr"
                        "fecha" => "2006"
                        "volumen" => "7"
                        "paginaInicial" => "79"
                        "paginaFinal" => "108"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16458610"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La funci&#243;n de la aur&#237;cula izquierda est&#225; alterada en algunos pacientes con ictus criptog&#233;nico&#58; potenciales implicaciones en su evaluaci&#243;n y tratamiento"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Sanchis"
                            1 => "S&#46; Montserrat"
                            2 => "V&#46; Obach"
                            3 => "&#193;&#46; Cervera"
                            4 => "&#193;&#46; Chamorro"
                            5 => "B&#46; Vidal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rec.2015.11.033"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Cardiol"
                        "fecha" => "2016"
                        "volumen" => "69"
                        "paginaInicial" => "650"
                        "paginaFinal" => "656"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26949013"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Left atrial strain is a surrogate marker for detection of atrial fibrillation in cryptogenic strokes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Pagola"
                            1 => "T&#46; Gonz&#225;lez-Alujas"
                            2 => "A&#46; Flores"
                            3 => "M&#46; Muchada"
                            4 => "D&#46; Rodriguez-Luna"
                            5 => "L&#46; Ser&#243;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2014"
                        "volumen" => "45"
                        "paginaInicial" => "e164"
                        "paginaFinal" => "e166"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0135"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is isolated aphasia a typical presentation of presumed cardioembolic transient ischemic attactk or stroke&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46;F&#46;M&#46; Fennis"
                            1 => "A&#46; Compter"
                            2 => "M&#46;W&#46; van den Broek"
                            3 => "P&#46;J&#46; Koudstaal"
                            4 => "A&#46; Algra"
                            5 => "P&#46;J&#46; Koeheler"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000348696"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cerebrovasc Dis"
                        "fecha" => "2013"
                        "volumen" => "35"
                        "paginaInicial" => "337"
                        "paginaFinal" => "340"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23615539"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0140"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Left atrial appendage morphology in patients with suspected cardiogenic stroke without known atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Korhonen"
                            1 => "A&#46; Muuronen"
                            2 => "O&#46; Arponen"
                            3 => "P&#46; Mustonen"
                            4 => "M&#46; Hedman"
                            5 => "P&#46; Jakala"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "PLoS ONE"
                        "fecha" => "2015"
                        "volumen" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Left atrial enlargement and stroke recurrence&#58; the Northern Manhattan Stroke Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Yaghi"
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                            3 => "J&#46;Z&#46; Willey"
                            4 => "K&#46; Cheung"
                            5 => "M&#46;R&#46; Di Tullio"
                          ]
                        ]
                      ]
                    ]
                  ]
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            ]
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Article information
ISSN: 21735808
Original language: English
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