JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
The role of the TAPSE/PASP ratio in the prediction of paroxysmal atrial fibrillation in patients with acute ischemic stroke
Abstract
Aims: Atrial fibrillation (AF) remains the most prevalent cause of cardioembolic stroke. Paroxysmal AF (PAF) is often difficult to be diagnosed and is sometimes first detected during embolic stroke. Yet, TAPSE and PASP can be easily revealed in routine transthoracic echocardiography (TTE). Then, the TAPSE/PASP ratio is often shown to have prognostic significance in many cardiac disorders. Nevertheless, the insufficient scholarly knowledge of the relationship between this ratio and the development of PAF became the primary motive of the present study.
Methods: We carried out this study with 114 patients experiencing acute ischemic stroke without a previous diagnosis of AF. We noted down the patients’ blood parameters and prescribed drugs and calculated TAPSE/PASP ratio relying on their TTE findings. We also recorded the 24-hour heart rhythm findings of each patient through Holter monitoring. After categorizing PAF attacks (i.e.,PAF attack was (not) observed), we explored any statistical relationship between the TAPSE/PASP ratio and the presence of PAF.
Results: The findings revealed a significant difference between the TAPSE/PASP ratios between the groups with PAF (0.62±0.07) and without PAF (0.77±0.08). Moreover, the receiver operating characteristic (ROC) curve analysis yielded the TAPSE/PASP ratio to demonstrate a diagnostic value in predicting PAF (area under the ROC curve [AUC]=0.89;82.7%; p<0.001). Besides, the TAPSE/PASP ratio measured <0.67 at admission was found to have 87.1% sensitivity and 82.7% specificity in predicting PAF. Finally, the multivariate analysis showed the TAPSE/PASP ratio to be a significant risk factor for PAF (odds ratio [OR]=2.971;95% confidence interval [CI]=1.073-8.959; p=0.000).
Conclusion: Overall, a low TAPSE/PASP ratio (<0.67) may be a precursor of the presence of PAF in patients.

Keywords : Acute ischemic stroke, tricuspid annular plane systolic excursion, mean pulmonary artery systolic pressure, paroxysmal atrial fibrillation

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Article available in :
Volume 4, Issue 4, 2023
Page : 355-361
https://doi.org/10.47582/jompac.1338419
Article Information
Received : 05 Ağu 2023
Accepted : 29 Ağu 2023
Published : 30 Ağu 2023
Corresponding Author :

Tolga Çakmak: Departman of Cardiology, Balıkesir Atatürk City Hospital, University of Health Sciences, Balıkesir, Turkey

[email protected]
Citation : Çakmak T, Şafak Ö. The role of the TAPSE/PASP ratio in the prediction of paroxysmal atrial fibrillation in patients with acute ischemic stroke. J Med Palliat Care. 2023;4(4):355-361.

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