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Association between left atrial function assessed by speckle-tracking echocardiography and the presence of left atrial appendage thrombus in patients with atrial fibrillation [Anatol J Cardiol]
Anatol J Cardiol. 2017; 18(1): 15-22 | DOI: 10.14744/AnatolJCardiol.2017.7613  

Association between left atrial function assessed by speckle-tracking echocardiography and the presence of left atrial appendage thrombus in patients with atrial fibrillation

Karolina Kupczynska, Blazej W. Michalski, Dawid Miskowiec, Jaroslaw D. Kasprzak, Paulina Wejner- Mik, Katarzyna Wdowiak- Okrojek, Piotr Lipiec
Department of Cardiology, Medical University of Lodz, Bieganski Hospital; Lodz-Poland

Objective: The aim of the study was to investigate whether the deformation of left atrium (LA) measured by speckle-tracking analysis (STE) is associated with the presence of LA appendage thrombus (LAAT) during non-valvular atrial fibrillation (AF).
Methods: Eighty-seven patients (mean age 67 years, 59% men) were included to retrospective cross-sectional study. On top of standard echocardiography we assessed: LA longitudinal systolic strain (LS), systolic (LSSR) and early diastolic strain rate (LESR) in four-chamber and two-chamber apical views. All patients underwent transesophageal echocardiography disclosing LAAT in 36 (41%) patients.
Results: Subgroups with and without thrombi did not differ with regard to clinical characteristics. Univariate factors associated with LAAT were as follows: CH2ADS2-VASc Score, left ventricular ejection fraction (LVEF), LV mass, and STE measurements. In a multivariate model only LVEF (p=0.002), LS (p=0.02), LESR (p=0.008), and LSSR (p=0.045) were independently associated with LAAT presence. Moreover, LVEF and LA STE measurements provided incremental value over the CH2ADS2-VASc Score.
Conclusion: Speckle-tracking TTE may be used to describe LA reservoir and conduit function during AF, allowing the identification of patients with higher risk of LAAT and providing incremental value over the CH2ADS2-VASc Score.

Keywords: heart failure, left atrial deformation, left atrial strain, left atrial strain rate, left ventricular systolic dysfunction, thromboembolism


Karolina Kupczynska, Blazej W. Michalski, Dawid Miskowiec, Jaroslaw D. Kasprzak, Paulina Wejner- Mik, Katarzyna Wdowiak- Okrojek, Piotr Lipiec. Association between left atrial function assessed by speckle-tracking echocardiography and the presence of left atrial appendage thrombus in patients with atrial fibrillation. Anatol J Cardiol. 2017; 18(1): 15-22

Corresponding Author: Karolina Kupczynska, Poland


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