Program

Lecture Abstract：
Cardioembolic stroke arises from a spectrum of structural and functional cardiac abnormalities, with atrial fibrillation (AF) representing the most recognized clinical substrate. Beyond rhythm diagnosis and conventional clinical risk factors, cardiac imaging provides important insights into the underlying atrial cardiomyopathy and thromboembolic substrate. Echocardiography remains the cornerstone of evaluation, allowing assessment of left atrial (LA) size and function, left atrial appendage thrombus, and spontaneous echo contrast. Advanced speckle-tracking echocardiography further demonstrates that impaired LA strain and strain rate are associated with ischemic stroke risk in patients with AF, supporting the role of functional atrial assessment in risk stratification. Cardiac magnetic resonance extends this evaluation through tissue characterization, particularly quantification of LA fibrosis. Emerging evidence showing increased LA fibrosis in embolic stroke of undetermined source highlights the concept of atrial cardiomyopathy as a potential thromboembolic substrate even without documented AF. This presentation will illustrate the evolving role of multimodality cardiac imaging, from echocardiography to MRI, in understanding and assessing stroke risk.