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Background: The left atrial septal pouch (LASP) is a small anatomical septal recess in the heart that has been linked with cardioembolic events. A systematic appraisal of the existing literature is necessary to establish a better understanding of the risk as studies continue to indicate a correlation between LASPs and cryptogenic strokes.
Objectives: To determine the level of association between the presence of LASP and the risk of developing cryptogenic stroke.
Methods: We searched PubMed, EMBASE and Scopus for studies comparing the prevalence of LASP in patients with cryptogenic stroke against non-cryptogenic stroke control groups from inception till December, 2023. The Newcastle Ottawa scale was used for quality assessment and Comprehensive Meta-Analysis Version 3.3 was used for data analysis with odds ratio (OR) as the effect measure.
Results: Our review included a total of 10 retrospective, observational studies published between 2010 to 2022. A total of 683 cases of cryptogenic strokes were identified, out of which 33.1 % (n = 271) were associated with a LASP. Among the non-cryptogenic stroke controls (n = 2641), LASP was present in 20.6 % cases (n = 476). The aggregate OR for cryptogenic stroke was 1.618 times greater than non-cryptogenic stroke (p < 0.001) among LASP cases, CONCLUSION: The presence of a septal pouch in the left atrium is significantly linked to a higher risk of developing cryptogenic strokes. As a potential site of thrombus formation and subsequent dislodgement, further large-scale studies are necessary to establish the guidelines for management and prophylaxis to prevent embolic events.
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http://dx.doi.org/10.1016/j.cpcardiol.2024.102400 | DOI Listing |
Cardiovasc Revasc Med
August 2025
Department of Cardiology, Guthrie Robert Packer Hospital, Sayre, PA 18840, USA. Electronic address:
Embolic stroke of undetermined source (ESUS) is a clinical event with an undelineated embolic etiology after the initial stroke workup. Once stroke specialists confirm ESUS, evaluation of rhythm disorders such as atrial fibrillation, specific cardiac pathologies (cardiomyopathy, left atrial cardiopathy, left-atrial septal pouch, aortic or mitral valve disease, cardiac neoplasm, right-to-left shunts, or device-related thrombus), and acquired hypercoagulable states, which may occasionally be related to malignancy, should be performed. While most ESUS patients require appropriate antiplatelet therapy, certain subsets may require oral anticoagulation.
View Article and Find Full Text PDFElife
August 2025
Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, United States.
Phospholipase C isozymes (PLCs) hydrolyze phosphatidylinositol 4,5-bisphosphate (PIP) into inositol 1,4,5-trisphosphate (IP) and diacylglycerol (DAG), important signaling molecules involved in many cellular processes including Ca release from the endoplasmic reticulum (ER). encodes the PLCγ1 isozyme that is broadly expressed. Hyperactive somatic mutations of are observed in multiple cancers, but only one germline variant has been reported.
View Article and Find Full Text PDFJACC Clin Electrophysiol
July 2025
Sutter Heart & Vascular Institute, Sacramento, California, USA. Electronic address:
J Stroke Cerebrovasc Dis
September 2025
Beckman Laser Institute & Medical Clinic, University of California, Irvine, CA, USA; Department of Neurology, University of California, Irvine, CA, USA; Department of Pathology & Laboratory Medicine, University of California, Irvine, CA, USA. Electronic address:
Background: Cryptogenic stroke accounts for a substantial proportion of ischemic strokes and often poses a diagnostic challenge due to the limitations of the TOAST classification in identifying atypical mechanisms. The left atrial septal pouch (LASP) is a blind-ended pouch arising from the incomplete fusion of the septum primum and septum secundum and is mutually exclusive with a patent foramen ovale (PFO). LASP is typically diagnosed using transesophageal echocardiography (TEE), an imaging modality not routinely utilized in the evaluation of either cryptogenic stroke or a related entity, embolic stroke of unknown source (ESUS).
View Article and Find Full Text PDFJ Interv Card Electrophysiol
May 2025
Department of Electrophysiology, Hospital Juan Ramón Jiménez, Huelva, Spain.