Background: Atrial cardiopathy is a risk factor for cerebrovascular stroke. Greater LA size is linked to stroke in AF patients, but few data regarding population with sinus rhythm.

Aim: To investigate PA-TDI duration as a predictor of stroke in patients who initially presented with sinus rhythm and have normal LV systolic function.

Patients and methods: In our case-control study, we studied patients admitted to Zagazig university hospital with acute ischemic stroke. It included 156 patients with acute ischemic stroke and 50 control subjects. The left atrial diameter and left atrial volume index were assessed. The PA-TDI mean interval was assessed.

Results: There was no statistically significant difference between both groups regarding LA diameter (p: 0.3), LA volume index was larger in the stroke group (p: 0.01), PA-TDI duration was highly significant difference between both groups (165.94±21.695 versus 99.4±22.960, p: <0.001). ROC curve showed the best cutoff point for LA volume index is >42.2 ml/m2 for prediction of stroke with 52.8 % sensitivity, 80.8% specificity, p value is 0.005. ROC curve showed the best cutoff point for PA-TDI is >155.5 ms for prediction of stroke with p value: <0.001. Using multivariate logistic regression analysis showed that hypertension, LA volume index and PA-TDI duration are independent predictors of stroke (p: < 0.05, < 0.05, and < 0.001 respectively).

Conclusion: The assessment of electromechanical asynchrony by measuring the PA-TDI duration in population with sinus rhythm may help to predict patients at risk for stroke and thus may benefit from anticoagulant therapy.