Evaluation of left atrial deformation to predict left atrial stasis in patients with non-valvular atrial fibrillation – a pilot-study
نویسندگان
چکیده
BACKGROUND Speckle tracking-derived strain and strain rate are recently available parameters to assess left atrial (LA) deformation. We hypothesized that such new parameters could be of interest to evaluate the risk of LA stasis among patients with atrial fibrillation (AF). METHODS Single-centre study enrolling all patients with non-valvular AF lasting longer than 48 hours for whom no therapeutic anticoagulation was given in the preceding 3 weeks and who were assessed through transesophageal and transthoracic echocardiogram during a 6 month time interval. LA deformation was assessed by transthoracic echocardiogram through speckle tracking analysis, whereas LA stasis parameters were sought on transesophageal echocardiogram. RESULTS Among the 82 assessed patients, LA appendage thrombi or sludge were found in 16 (19.5%). A moderate positive correlation was found between peak positive strain rate and maximum emptying velocity (r = 0.589; P <0.001) and peak positive strain rate and maximum filling velocity of the LA appendage (r = 0.651; P <0.001). Peak negative strain rate was also found to be associated with both maximum emptying velocity (r = -0.513; P <0.001) and maximum filling velocity of the LAA (r = -0.552; P <0.001). AF duration, peak negative strain rate and time-to-peak positive strain were independent predictors of LAA thrombi or sludge on multivariate analysis logistic regression. The area under the curve for the estimated probabilities using the obtained logistic regression model was 0.89 (95%CI 0.81-0.96; P <0.001). CONCLUSION Our findings suggest that LA mechanical dysfunction assessed through speckle tracking may be of interest to predict LA stasis in the setting of AF.
منابع مشابه
Mean platelet volume is associated with the presence of left atrial stasis in patients with non-valvular atrial fibrillation
BACKGROUND Mean platelet volume has been associated with stroke in patients with atrial fibrillation. However, its role as a predictor of left atrial stasis, assessed by transesophageal echocardiography, in patients with non-valvular atrial fibrillation has not yet been clarified. METHODS Single center cross-sectional study comprising 427 patients admitted to the emergency department due to s...
متن کاملA Semi-Automated Algorithm for Segmentation of the Left Atrial Appendage Landing Zone: Application in Left Atrial Appendage Occlusion Procedures
Background: Mechanical occlusion of the Left atrial appendage (LAA) using a purpose-built device has emerged as an effective prophylactic treatment in patients with atrial fibrillation at risk of stroke and a contraindication for anticoagulation. A crucial step in procedural planning is the choice of the device size. This is currently based on the manual analysis of the “Device Landing Zone” fr...
متن کاملIncidence of Atrial Fibrillation after Coronary Artery Bypass Graft Surgery and Its Risk Factors in Shiraz, Iran during 2017-18
Background and Objectives: Atrial fibrillation is one of the most common disorientations after coronary artery bypass graft surgery and can affect the chance of survival in the first year after surgery. The present study aimed to determine the incidence of atrial fibrillation after coronary artery bypass graft surgery and its risk factors. Methods: This cross-sectional study was performed on...
متن کاملClinical Significance of P Wave Dispersion in Prediction of Atrial Fibrillation in Patients with Acute Myocardial Infarction
Background: P wave dispersion (PWD) is defined as the difference between the maximum P wave duration (Pmax) and the minimum P wave duration (Pmin) in 12-leads of the surface electrocardiography. The aim of this study was to evaluate the values of PWD during atrial fibrillation (AF) after acute myocardial infarction (AMI). Methods: We prospectively evaluated atrial rhythms of 350 patients (251 m...
متن کاملIncreased levels of red cell distribution width is correlated with presence of left atrial stasis in patients with non-valvular atrial fibrillation
OBJECTIVE Red cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) have been found to be associated with non-valvular atrial fibrillation (AF) and cardiovascular diseases. However, correlation of these parameters with presence of left atrial (LA) thrombus and/or spontaneous echo contrast (SEC) in patients with non-valvular AF has not been clarified. This study was an investiga...
متن کامل