The value of left atrial strain and strain rate in predicting left atrial appendage stasis in patients with nonvalvular atrial fibrillation.

BACKGROUND This study aimed to investigate the value of left atrial (LA) strain and strain rate (S/SR) by transthoracic echocardiography (TTE) in predicting left atrial appendage (LAA) stasis, in order to find a way for LAA stasis screening which is easily performed in patients with nonvalvular atrial fibrillation (NVAF). METHODS One hundred and thirty NVAF patients prepared for AF ablation were enrolled. TTE and transesophageal echocardiography (TEE) were performed in all patients. LA S/SR in each phase was analyzed off-line. LAA blood flow state and LAA function were assessed by using TEE. RESULTS LA S/SRs during atrial reservoir phase (LA Sres/SRres) were significantly negatively cor-related with LAA spontaneous echo contrast (SEC) grade (r = -0.567 and -0.520, respectively; all p < 0.01), and positively correlated with LAA emptying fraction (r = 0.602 and 0.619, respectively; all p < 0.01) and with LAA peak emptying flow velocity (r = 0.623 and 0.642, respectively; all p < 0.01). The multivariate logistic regression analysis showed LA Sres to be the strongest independent predictor of LAA stasis, followed by LA volume index. LA Sres < 13% was recommended to predict LAA stasis with sensitivity of 90% and specificity of 74%. CONCLUSIONS LA Sres by TTE can noninvasively predict LAA stasis and may be used as a screening tool to assist in the detection of LAA stasis in patients with NVAF. (Cardiol J 2018; 25, 1: 87-96).