Role of transthoracic left atrial appendage wall motion velocity in patients with persistent atrial fibrillation and a low CHADS2 score

Abstract Background and purpose Thromboembolic risk has been examined by semi-invasive transesophageal echocardiography. We assessed the risk of thrombogenesis in patients with persistent atrial fibrillation (AF) noninvasively by using transthoracic tissue Doppler echocardiography (TDE) in relation...

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Published in:Journal of cardiology 2012-10, Vol.60 (4), p.310-315
Main Authors: Yoshida, Naoyasu, PhD, Okamoto, Mitsunori, MD, FJCC, Hirao, Hidekazu, MD, Nanba, Kiyomi, MSc, Kinoshita, Hiroki, MD, Matsumura, Hiroya, MD, Fukuda, Yukihiro, MD, Ueda, Hironori, MD, FJCC
Format: Article
Language:English
Subjects:
Aged
Atrial Appendage - diagnostic imaging
Atrial fibrillation
Atrial Fibrillation - complications
Atrial Fibrillation - diagnostic imaging
Cardiovascular
Cerebral embolism
CHADS2 score
Echocardiography
Echocardiography, Doppler
Echocardiography, Transesophageal
Female
Humans
Left atrial function
Male
Thromboembolism - diagnosis
Thromboembolism - etiology
Tissue Doppler echocardiography
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Summary:Abstract Background and purpose Thromboembolic risk has been examined by semi-invasive transesophageal echocardiography. We assessed the risk of thrombogenesis in patients with persistent atrial fibrillation (AF) noninvasively by using transthoracic tissue Doppler echocardiography (TDE) in relation to a low CHADS2 score. Methods Eighty patients with persistent AF underwent both transthoracic and transesophageal echocardiography. Peak left atrial appendage (LAA), wall motion velocity (WV) during LAA contraction was measured by transthoracic and transesophageal TDE. LAA flow velocity was also determined by transesophageal echocardiography. Results Transthoracic LAAWV could be measured in 78 of the 80 patients, and the values were closely correlated with transesophageal TDE values ( r = 0.98) and with transesophageal LAA flow velocity ( r = 0.82). Transthoracic LAAWV was significantly lower with increasing spontaneous echo contrast (SEC) severity (severe SEC, mild SEC, no SEC: 5.7 ± 2.4, 10.2 ± 3.3, and 14.5 ± 5.5 cm/s, respectively). Severe SEC was noted in 31 of 61 patients with a CHADS2 score ≤2, in 19 of 46 patients with a CHADS2 score ≤1 and in 6 of 21 patients with a CHADS2 score = 0. For diagnosing severe SEC, a transthoracic LAAWV
ISSN:0914-5087
1876-4738
DOI:10.1016/j.jjcc.2012.05.007