Low Wall Velocity of Left Atrial Appendage Measured by Trans-Thoracic Echocardiography Predicts Thrombus Formation Caused by Atrial Appendage Dysfunction
published online 01 April 2010.
Background
Atrial fibrillation is associated with ischemic stroke because of thrombi that form within the left atrial appendage (LAA). The aim of this study was to develop a new parameter for LAA function that is easily performed using transthoracic echocardiography (TTE).
Methods
TTE and transesophageal echocardiography were performed in 106 patients with stroke. LAA wall motion velocity (TTE-LAWV) was measured using Doppler tissue imaging at the LAA tip.
Results
TTE-LAWV was significantly lower in patients with atrial fibrillation and LAA thrombus than in those with atrial fibrillation and no LAA thrombus and in sinus rhythm (7.5 ± 1.9 vs 10.0 ± 3.4 and 13.8 ± 5.7 cm/s, respectively, P < .05). TTE-LAWV was significantly correlated with LAA emptying flow velocity (R = 0.462, P < .05). The multivariate logistic regression analysis showed that TTE-LAWV < 8.7 cm/s was an independent predictor of LAA thrombus formation (odds ratio, 9.473; 95% confidence interval, 1.172-76.55; P < .05).
Conclusion
TTE-LAWV can noninvasively evaluate LAA dysfunction and assist in the detection of LAA thrombus.
aDepartment of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
bDepartment of Neurosurgery, Yamagata University School of Medicine, Yamagata, Japan
cYamagata Prefectural Shinjo Hospital, Yamagata, Japan
Reprint requests: Tetsu Watanabe, MD, PhD, Yamagata University School of Medicine, Department of Cardiology, Pulmonology, and Nephrology, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
This work was supported by a grant-in-aid from the Global COE program of the Japan Society for the Promotion of Science and by a grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan (grants 19790513, 19790515, and 20590813).
ABSTRACT