Evidence map›Paper›PMID 37612538›Full record

ArticleJournal of neurology2023

Left atrial appendage flow velocity predicts occult atrial fibrillation in cryptogenic stroke: a CRYPTON-ICM registry.

Yuji Ueno, Nobukazu Miyamoto, Kenichiro Hira, Ryosuke Doijiri, Hidekazu Yamazaki, Kazutaka Sonoda, Junpei Koge, Tomonori Iwata, Kenichi Todo, Hiroshi Yamagami and 8 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 8 institutions in 1 country.

Yuji UenoDepartment of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan. yuji-u@juntendo.ac.jp.ORCID http://orcid.org/0000-0002-8617-3695
Nobukazu MiyamotoDepartment of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Kenichiro HiraDepartment of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Ryosuke DoijiriDepartment of Neurology, Iwate Prefectural Central Hospital, Morioka, Japan.
Hidekazu YamazakiDepartment of Neurology, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan.
Kazutaka SonodaDepartment of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
Junpei KogeDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Tomonori IwataDepartment of Neurology, Tokai University, Isehara, Japan.
Kenichi TodoDepartment of Neurology, Osaka University Graduate School of Medicine, Suita, Japan.
Hiroshi YamagamiDepartment of Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Naoto KimuraDepartment of Neurology, Iwate Prefectural Central Hospital, Morioka, Japan.
Masafumi MorimotoDepartment of Neurology, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan.
Daisuke KondoDepartment of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
Shuhei OkazakiDepartment of Neurology, Osaka University Graduate School of Medicine, Suita, Japan.
Masatoshi KogaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Eiichiro NagataDepartment of Neurology, Tokai University, Isehara, Japan.
Nobutaka HattoriDepartment of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
CRYPTON-ICM investigators
Juntendo University · JPIwate Prefectural Central Hospital · JPNational Cerebral and Cardiovascular Center · JPOhkawara Neurosurgical Hospital · JPSaiseikai Fukuoka General Hospital · JPThe University of Osaka · JPTokai University · JPOsaka National Hospital · JP

Funding

Japan Society for the Promotion of Science 20K07909
6 · The paper itself

Abstract

backgroundAn insertable cardiac monitor (ICM) and transesophageal echocardiography (TEE) are useful for investigating potential embolic sources in cryptogenic stroke, of which atrial fibrillation (AF) is a critical risk factor for stroke recurrence. The association of left atrial appendage flow velocity (LAA-FV) on TEE with ICM-detected AF is yet to be elucidated.

methodsCRYPTON-ICM (CRYPTOgenic stroke evaluation in Nippon using ICM) is a multicenter registry of cryptogenic stroke with ICM implantation, and patients whose LAA-FV was evaluated on TEE were enrolled. The primary outcome was the detection of AF (> 2 min) on ICM. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off of LAA-FV, and factors associated with ICM-detected AF were assessed.

resultsA total of 307 patients (age 66.6 ± 12.3 years; 199 males) with median follow-up of 440 (interquartile range 169-726) days were enrolled; AF was detected in 101 patients. The lower-tertile LAA-FV group had older age, more history of congestive heart failure, and higher levels of B-type natriuretic peptide (BNP) or N-terminal proBNP (all P < 0.05). On ROC analysis, LAA-FV < 37.5 cm/s predicted ICM-detected AF with sensitivity of 26.7% and specificity of 92.2%. After adjustment for covariates, the lower tertile of LAA-FV (hazard ratio [HR], 1.753 [1.017-3.021], P = 0.043) and LAA-FV < 37.5 cm/s (HR 1.987 [1.240-3.184], P = 0.004) predicted ICM-detected AF.

conclusionsLAA-FV < 37.5 cm/s predicts AF. TEE is useful not only to evaluate potential embolic sources, but also for long-term detection of AF on ICM by measuring LAA-FV in cryptogenic stroke. http://www.umin.ac.jp/ctr/ (UMIN000044366).

Indexed as

Atrial AppendageAtrial FibrillationIschemic StrokeStrokeAgedEchocardiography, TransesophagealHumansMaleMiddle AgedRegistriesAtrial fibrillationCryptogenic strokeInsertable cardiac monitorLeft atrial appendage flow velocityTransesophageal echocardiography

Identifiers

PMID37612538
OpenAlexW4386090889

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.