Atrial cardiomyopathy: An emerging cause of the embolic stroke of undetermined source

Journal article


Ning, Yuye, Tse, G., Luo, Guogang and Li, Guoliang 2021. Atrial cardiomyopathy: An emerging cause of the embolic stroke of undetermined source. Frontiers in Cardiovascular Medicine. 8, p. 674612. https://doi.org/10.3389/fcvm.2021.674612
AuthorsNing, Yuye, Tse, G., Luo, Guogang and Li, Guoliang
AbstractNearly 30% of ischemic strokes have an unknown cause, which are referred to as cryptogenic strokes (CS). Imaging studies suggest that a large proportion of these patients show features that are consistent with embolism, and thus the term embolic stroke of undetermined source (ESUS) was proposed to describe these CS patients. Atrial cardiomyopathy predisposes to thrombus formation and thus embolic stroke even in the absence of atrial fibrillation (AF). This may provide a mechanistic link with ESUS, suggesting that anticoagulant therapy may be more beneficial than antiplatelet therapy in ESUS patients with atrial cardiomyopathy. The present review discusses the concept of atrial cardiomyopathy and ESUS and the relationship between them based on the mechanisms and clinical evidence, suggests that atrial cardiomyopathy may be a potential mechanism of ESUS, and highlights a theoretical basis that supports that anticoagulant therapy may be more applicable to ESUS patients with atrial cardiomyopathy and aims to help us better understand and identify the risk of ESUS, thereby improving the management of these patients in clinical practice.
KeywordsRisk stratification; Structural heart disease; Cardiac rhythm abnormalities; Atrial cardiomyopathy; Embolic stroke of undetermined source
Year2021
JournalFrontiers in Cardiovascular Medicine
Journal citation8, p. 674612
PublisherFrontiers Media S.A.
ISSN2297-055X
Digital Object Identifier (DOI)https://doi.org/10.3389/fcvm.2021.674612
Official URLhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.674612/full
Publication dates
Online09 Aug 2021
Print01 Jan 2021
Publication process dates
Accepted30 Jun 2021
Deposited30 Sep 2021
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LicenseCC BY
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