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Objective: Detection of paroxysmal atrial fibrillation (PAF) in patients with acute stroke is often difficult. Dilatation of left atrium dimension (LAD) and increased levels of brain natriuretic peptide (BNP) are reported to indicate cerebral embolism due to PAF. We assessed the usefulness of chest X-ray in predicting LAD and BNP among patients with acute cerebral infarction. Methods: We included 141 consecutive patients with cerebral infarction [107 cerebral thromboses (cerebral thrombosis group)] and 34 cardiogenic cerebral embolisms due to PAF (PAF group). Transthoracic echocardiography (TTE) was used to evaluate LAD (TTE-LA). On chest X-ray, heart diameter at the third aortic arch (XPLA) and XP-LA divided by maximum intrathoracic diameter (XP-LA ratio) were measured. Results: TTE-LA, XP-LA, XP-LA ratio and BNP levels were significantly higher in PAF group compared with those in cerebral thrombosis group. XP-LA had a significant positive correlation with TTE-LA (r = 0.332, p < 0.0001) and BNP (r = 0.292, p < 0.001). XP-LA ratio also showed a significant correlation with TTE-LA (r = 0.210, p = 0.0126) and BNP (r = 0.515, p < 0.0001). Conclusion: We suggest chest X-ray is a simple and useful tool for predicting LAD and BNP.

Utility of chest X-ray in predicting left atrium dimension and brain natriuretic peptide