Left atrial function in people with unexplained (cryptogenic) stroke.

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This multicenter retrospective study analyzes echocardiographic images from adults referred for stroke evaluation to determine whether impaired left atrial (LA) strain is associated with cryptogenic stroke and with recurrent events. Echocardiographic images will be reanalyzed offline using standardized speckle-tracking software and de-identified images and clinical data will be collected in a central core laboratory at the University of Pittsburgh. Clinical follow-up data on recurrent stroke, new atrial fibrillation, and mortality will be used to compare outcomes across LA strain measures. The aim is to validate LA strain as a noninvasive biomarker of atrial cardiopathy that could help explain otherwise unexplained embolic strokes.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Adult patients (age \> 18 years and \< 80 years) who had a complete transthoracic echocardiography (TTE) exam at the University of Pittsburgh Medical Center (UPMC) Presbyterian Echocardiography Lab with a referral diagnosis of suspected stroke.

  2- Patients with an established diagnosis of stroke by stroke neurologists.

  3- Patients in sinus rhythm documented at the time of referral.

  4- Availability of adequate echocardiographic images for strain quantification.

  5- Clinical follow-up data available for evaluation of study endpoints, including stroke recurrence, atrial fibrillation development, and mortality.

  6- Patients from collaborating centers will be included with de-identified echocardiographic images and clinical data meeting the above criteria.

Exclusion Criteria:

Incomplete or technically difficult transthoracic echocardiography (TTE) studies and studies from subjects younger than 18 years of age will be excluded. Additional exclusion criteria include:

1- Pre-existing atrial fibrillation (AF): Patients with a documented history AF prior to the index echocardiography study will be excluded because it is well established that AF justifies cryptogenic stroke requiring anticoagulation.

2 -Structural heart disease: Patients with significant structural abnormalities, such as moderate or severe mitral stenosis, moderate or severe mitral regurgitation, prosthetic heart valves, devices in the left atrium, atrial septal defect or patent foramen ovale will be excluded as these conditions are known causes of stroke and abnormal left atrial function.

3- Coagulopathy: Patient having disease leading to hypercoagulable (thrombus formation) state will be excluded (presence of cancer, antiphospholipid antibodies, hematological diseases).

4- Inadequate clinical follow-up: Patients with insufficient follow-up data or missing medical records that preclude evaluation of study endpoints (e.g., stroke recurrence, AF development) will be excluded unless death is documented.

5- Poor image quality for strain analysis: Patients having echo exams with inadequate image quality that prevent reliable strain quantification will be excluded.

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Where it's running

• UPMC Presbyterian
  Pittsburgh, Pennsylvania, United States Recruiting

Study contacts

• Principal investigator: Leyla E Sade, MD — University of Pittsburgh Medical Center
• Study coordinator: Leyla E Sade, MD
• Email: sadele2@upmc.edu
• Phone: 412-215-3464

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Other studies for the same condition or treatment. Recruiting studies are listed first.

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• Using a MEMO wearable patch to find atrial fibrillation after an unexplained stroke

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.