By Clinical Research News Staff 

April 23, 2025 | Researchers have identified "left atrial reservoir strain" as the best biomarker for predicting stroke and dementia risk, according to a new study published in the journal Stroke. The research, led by Dr. Lin Yee Chen of the University of Minnesota Medical School, compared various methods of detecting left atrial (LA) myopathy, an abnormality of the heart's left atrium that can indicate elevated risk even without atrial fibrillation (AFib). 

The study specifically compared P wave abnormalities from ECGs, NT-proBNP blood markers, and LA volume and strain parameters from echocardiograms. Left atrial reservoir strain, which measures the left atrium's ability to stretch, emerged as the superior indicator. Dr. Chen believes these findings could "transform the field" since previous clinical trials using anticoagulants to prevent strokes in people with LA myopathy have failed, possibly because they weren't using the optimal marker to identify appropriate participants. 

Based on these results, Dr. Chen's research group is planning a multi-center clinical trial to determine whether blood thinners can prevent stroke and dementia in individuals who previously experienced embolic strokes of undetermined source. The team will use LA reservoir strain to identify people with LA myopathy and randomize them to receive either an anticoagulant or aspirin. They plan to submit a grant application to the Patient-Centered Outcomes Research Institute (PCORI) this fall. 

The research challenges the long-held belief that AFib is the primary risk factor for stroke. Instead, Dr. Chen suggests that LA myopathy may be the underlying driver, regardless of whether AFib is present. This finding could redirect clinical efforts toward a more accurate target. 

While LA reservoir strain has "powerful prognostic relevance" for predicting various cardiovascular diseases beyond stroke and dementia, most echo labs currently ignore left atrial function measurements. Dr. Chen's team is working to establish LA reservoir strain as a standard metric in cardiac evaluation and to develop standardized measurement methodologies. 

Read the full story by Deborah Borfitz on Diagnostics World News.