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

• 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
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2012.05.007

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