Clinical Research
Clinical study on influencing factors for left atrial appendage spontaneous echo contrast or thrombosis in patients with non-valvular atrial fibrillation
Lanlan Sun, Yidan Li, Li Wang, Lingyun Kong, Hong Li, Xiuzhang Lyu
Published 2017-04-25
Cite as Chin J Ultrasonogr, 2017, 26(4): 282-286. DOI: 10.3760/cma.j.issn.1004-4477.2017.04.002
Abstract
ObjectiveTo investigate the influencing factors for left atrial appendage(LAA) spontaneous echo contrast (SEC) or thrombosis in patients with non-valvular atrial fibrillation(NVAF) and normal left ventricular ejection fraction(LVEF).
MethodsThis study prospectively enrolled 255 patients with NVAF [paroxysmal atrial fibrillation(PaAF) 196 cases and persistent atrial fibrillation(PeAF) 59 cases]. Patients were divided into two groups according to the findings on transesophageal echocardiography(TEE): positive group with the presence of the LAA SEC or thrombosis (group Ⅰ) and negative group(group Ⅱ) without this two presences. The clinical and echocardiographic data were compared between the two groups. The multivariate logistic regression analysis was used to explore the independent risk factors for development of LAA SEC or thrombosis. Receiver operating characteristic (ROC) curve was performed to determine the predictive value of the factors.
ResultsA total of 255 patients were enrolled. There were 26 cases(10.2%) in group Ⅰ, and 229 cases (89.8%) in group Ⅱ. The age, NT-proBNP, occurrence rate of PeAF, left atrial volume index(LAVI), and LAA orifice long diameter and depth were higher in group Ⅰ than those in group Ⅱ(all P<0.01). The left atrial appendage emptying velocity(LAAV), global left atrial longitudinal strain(GLALS) and LVEF were lower in group Ⅰ compared with those in group Ⅱ (all P<0.01). Multivariate logistic regression analysis and ROC curve showed that GLALS<12.2% and LAAV<31.2 cm/s were independent risk factors of LAA SEC or thrombosis in patients with NVAF and perserved LVEF.
ConclusionsThe impairment of left atrial and LAA function are potential risk factors for cardiogenic embolism. GLALS and LAAV can be used as useful referenced parameters for prediction of stroke in patients with NVAF.
Key words:
Echocardiography, transesophageal; Atrial fibrillation; Atrial function, left; Left atrial appendage; Spontaneous echo contrast; Strain
Contributor Information
Lanlan Sun
Department of Echocardiography, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Yidan Li
Li Wang
Lingyun Kong
Hong Li
Xiuzhang Lyu