Is the Macruz Index a Marker of Atrial Cardiomyopathy in Stroke Patients With Sinus Rhythm?

Abstract

The Macruz index has recently gained renewed interest as a potential marker of atrial remodeling in stroke patients without documented atrial fibrillation. In their study, Arslan and Söner reported significantly elevated Macruz index values in stroke patients with sinus rhythm, highlighting its possible association with subclinical atrial pathology. In this letter, we discuss the clinical implications of these findings within the contemporary framework of atrial cardiomyopathy. We emphasize the importance of volumetric and functional atrial assessment, including left atrial volume index and strain imaging, as well as complementary electrocardiographic and biomarker-based parameters. We also address methodological considerations related to rhythm monitoring, control group selection, and confounding clinical factors. Further studies integrating multimodal imaging and prolonged rhythm surveillance may help clarify the pathophysiological and prognostic significance of the Macruz index in this population.