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Short stature and ischemic stroke in nonvalvular atrial fibrillation: New insight into the old observation.

 Jeonggeun Moon  ;  Hye-Jeong Lee  ;  Young Jin Kim  ;  Jong-Youn Kim  ;  Hui-Nam Pak  ;  Jong-Won Ha  ;  Moon-Hyoung Lee  ;  Boyoung Joung 
 International Journal of Cardiology, Vol.174(3) : 541-544, 2014 
Journal Title
 International Journal of Cardiology 
Issue Date
Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology* ; Atrial Fibrillation/physiopathology ; Body Height/physiology* ; Brain Ischemia/diagnosis ; Brain Ischemia/epidemiology* ; Brain Ischemia/physiopathology ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Stroke/diagnosis ; Stroke/epidemiology* ; Stroke/physiopathology
Atrial fibrillation ; Diastolic function ; Echocardiography ; Height ; Stroke
BACKGROUND: For decades, repeated epidemiologic observations have been made regarding the inverse relationship between stature and cardiovascular disease, including stroke. However, the concept has not been fully evaluated in patients with atrial fibrillation (AF). We investigated whether patient's height is associated with ischemic stroke in patients with nonvalvular AF and attempted to ascertain a potential mechanism. METHODS: All 558 AF patients were enrolled: 211 patients with ischemic stroke (144 men, 68 ± 10 years) and 347 no-stroke patients (275 men, 56 ± 11 years) as a control group. Clinical characteristics and echocardiographic parameters were compared between the two groups. RESULTS: (1) Stroke patients were shorter than those in the control group (164 ± 8, vs. 169 ± 8 cm, p<0.001). However, body mass index failed to predict ischemic stroke; (2) Short stature (OR 0.93, 95% CI 0.91-0.95, p<0.001) along with left atrial (LA) anterior-posterior diameter and diastolic mitral inflow velocity (E) to diastolic mitral annuls velocity (E') (E/E') were independent predictor of stroke; (3) Height showed inverse correlation with E/E' independently, even after adjusting for other variables, including age, sex, and body weight, and comorbidities β -0.20, p=0.003); (4) LA size showed no correlation with stature (R=-0.06, p=0.18), whereas left ventricular size increases according to height of patients. CONCLUSIONS: Short stature is associated with occurrence of ischemic stroke and diastolic dysfunction in patients with AF and preserved systolic function. Height is a non-modifiable risk factor of stroke and might be more important than obesity in Asian AF patients, who are relatively thinner than western populations.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
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