Abstract 10874: Left Atrial Appendage Wall Velocity Obtained by Transthoracic Echocardiography is a Feasible Marker for Long Term Prognosis in Patients With Heart Failure

• Published in: Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A10874-A10874
• Main Authors: Hashimoto, Naoto, Watanabe, Tetsu, Tamura, Harutoshi, Tsuchiya, Hayato, Wanezaki, Masahiro, Kato, Shigehiko, Nishiyama, Satoshi, Arimoto, Takanori, Takahashi, Hiroki, Shishido, Tetsuro, Watanabe, Masafumi
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

IntroductionIt was reported that left atrial (LA) remodeling is occurred in patients with heart failure (HF), and increased LA volume index (LAVI) is a feasible predictor for poor prognosis of HF. It was reported that LA remodeling is associated with LA appendage (LAA) dysfunction. We previously reported that LAA wall motion velocity obtained by transthoracic echocardiography (LAWV) can noninvasively evaluate LAA dysfunction. However, it remains to be determined whether LAWV is useful for predicting poor prognosis in patients with HF.HypothesisWe hypothesized that LAWV can predict poor prognosis in patients with HF.MethodsWe performed transthoracic echocardiography at discharge in 228 consecutive patients who hospitalized for HF (133 males, 71 ± 13 years) and prospectively followed them up. LAWV was measured using Doppler tissue imaging at the LAA tip from the parasternal short-axis view on TTE imaging, as previously reported.ResultsThere were 86 patients with cardiac events (38%) including 14 cardiac deaths and 72 rehospitalizations for HF during a median follow-up period of 404 days (interquartile range 168-748 days). LAWV was significantly lower in patients with cardiac events than in those without. LAWV was significantly correlated with LAVI, LA peak systolic strain, the early mitral inflow velocity divided by the early diastolic annular velocity, and brain natriuretic peptide. LAWV was significantly decreasing with advancing left ventricular diastolic dysfunction grade. Cox multivariate hazard analysis revealed that LAWV was an independent predictor for cardiac events after adjusting for confounding factors (hazard ratio 0.57, 95% confidence interval 0.40-0.82, P < 0.05). Kaplan-Meier analysis demonstrated that significantly higher cardiac event rate was observed in patients with low LAWV (log-rank test, P = 0.019; Figure).ConclusionsLAWV may be a feasible marker for cardiac prognosis in patients with HF.