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01.03.2019 | original article

Left atrial appendage strain rate is associated with documented thromboembolism in nonvalvular atrial fibrillation

verfasst von: Monika Jankajova, M.D., PhD, Lucia Kubikova, M.D., Prof. Gabriel Valocik, M.D., PhD, Peter Candik, M.D., PhD, Prof. Peter Mitro, M.D., PhD, Marian Kurecko, M.D., Assoc. Prof. Frantisek Sabol, M.D., PhD, MPH, MBA, Adrian Kolesar, M.D, PhD, MPH, Maria Kubikova, M.D., PhD, Marianna Vachalcova, M.D., PhD, Marianna Dvoroznakova, M.D.

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 7-8/2019

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Summary

Background

The left atrial appendage (LAA) strain and strain rate have not yet been studied in the prediction of cardiac thromboembolism. Therefore, this study aimed to evaluate the significance of LAA strain and strain rate as assessed by speckle-tracking imaging in relation to documented thromboembolic events.

Methods

A group of 80 patients with a mean age of 65 years who were referred for electrical cardioversion of nonvalvular atrial fibrillation was retrospectively analyzed. Each patient underwent 2D transesophageal echocardiography (TEE). Velocity vector imaging (VVI)-derived LAA strain and strain rate in parallel with other conventional TEE predictors were analyzed in terms of their association with previous embolic stroke and peripheral embolization.

Results

By comparing the two groups of patients with (22/80) and without embolic events (58/80), patients with embolic events were older, had higher CHA₂DS₂-VASc scores, higher incidence of coronary artery disease and LAA thrombi, and worse LAA strain and strain rate. Moreover, patients without embolization more often used anticoagulants than patients with embolic events. After adjusting for the abovementioned embolic risk factors, only the CHA₂DS₂-VASc (congestive heart failure, hypertension, age ≥75 years [double weight], diabetes mellitus, stroke [double weight], vascular disease, age from 65 to 74 years, sex category) score and the LAA strain rate remained as significant predictors of embolic events.

Conclusion

The results of the study show that the VVI-derived LAA strain rate is a significant predictor of documented ischemic stroke and systemic thromboembolism in patients with nonvalvular atrial fibrillation. Its predictive power is similar to the predictive power of the CHA₂DS₂-VASc score.

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Titel: Left atrial appendage strain rate is associated with documented thromboembolism in nonvalvular atrial fibrillation
verfasst von: Monika Jankajova, M.D., PhD
Lucia Kubikova, M.D.
Prof. Gabriel Valocik, M.D., PhD
Peter Candik, M.D., PhD
Prof. Peter Mitro, M.D., PhD
Marian Kurecko, M.D.
Assoc. Prof. Frantisek Sabol, M.D., PhD, MPH, MBA
Adrian Kolesar, M.D, PhD, MPH
Maria Kubikova, M.D., PhD
Marianna Vachalcova, M.D., PhD
Marianna Dvoroznakova, M.D.
Publikationsdatum: 01.03.2019
Verlag: Springer Vienna
Erschienen in: Wiener klinische Wochenschrift / Ausgabe 7-8/2019
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI: https://doi.org/10.1007/s00508-019-1469-6

Springer Medizin Österreich

Summary

Background

Methods

Results

Conclusion

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