Atrial function in stroke

  • Research type

    Research Study

  • Full title

    Investigating the left atrial phenotype in patients with stroke using advanced magnetic resonance imaging

  • IRAS ID

    240825

  • Contact name

    Rohan Sajeev Wijesurendra

  • Contact email

    rohan.wijesurendra@cardiov.ox.ac.uk

  • Duration of Study in the UK

    2 years, 0 months, 1 days

  • Research summary

    Background
    Ischaemic stroke (a clinical condition occurring when the blood supply to a part of the brain is cut off)is strongly associated with atrial fibrillation AF (i.e. a common condition causing irregularities of the heart beat). Up to 15% of all strokes are ascribed to clinically diagnosed AF; in addition, the cause of stroke remains uncertain even after a complete diagnostic evaluation, in 20-40% of cases (“embolic strokes of uncertain source”) and AF may be responsible for a significant proportion of these cases. Additionally, several strands of evidence suggest that AF may be a marker of an abnormal atrial substrate or “atrial cardiopathy” (an overall dysfunction of the atrium) that could itself predispose to stroke, largely independently from the abnormal rhythm.
    Advanced non-invasive Magnetic Resonance Imaging (MRI) techniques may detect such atrial alterations and inform on possible mechanistic associations.

    Aims
    To compare the degree of left atrial stasis in patients with a recent ischaemic stroke versus matched patients (with the similar stroke risk as assessed by the CHA2DS2-VASc Score) in the presence or absence of a clinical diagnosis of AF.

    Study Design
    This is a BRC funded observational cross-sectional study. We plan to recruit patients with acute ischaemic stroke admitted to the John Radcliffe Oxford University Hospital. Stroke patients with an up-to-moderate level of disability will be investigated at a single time point, within 14 days of hospital admission, with a 7-day ECG monitoring, blood samples, and MRI scan of the brain and of the heart (+/- optional additional carotid scan) without exposure to contrast or ionizing radiations. Controls matched for stroke risk factors but with no previous history of stroke, will also be recruited and will undergo the same protocol as stroke participants. Additional optional extra-visits will be performed in a random selection of ~25% participants who consented to these options, in order to assess technique variability.

  • REC name

    Yorkshire & The Humber - Leeds East Research Ethics Committee

  • REC reference

    18/YH/0096

  • Date of REC Opinion

    16 Mar 2018

  • REC opinion

    Favourable Opinion