Low wall velocity of left atrial appendage measured by trans-thoracic echocardiography predicts thrombus formation caused by atrial appendage dysfunction

J Am Soc Echocardiogr. 2010 May;23(5):545-552.e1. doi: 10.1016/j.echo.2010.02.006. Epub 2010 Mar 31.

Abstract

Background: Atrial fibrillation is associated with ischemic stroke because of thrombi that form within the left atrial appendage (LAA). The aim of this study was to develop a new parameter for LAA function that is easily performed using transthoracic echocardiography (TTE).

Methods: TTE and transesophageal echocardiography were performed in 106 patients with stroke. LAA wall motion velocity (TTE-LAWV) was measured using Doppler tissue imaging at the LAA tip.

Results: TTE-LAWV was significantly lower in patients with atrial fibrillation and LAA thrombus than in those with atrial fibrillation and no LAA thrombus and in sinus rhythm (7.5 +/- 1.9 vs 10.0 +/- 3.4 and 13.8 +/- 5.7 cm/s, respectively, P < .05). TTE-LAWV was significantly correlated with LAA emptying flow velocity (R = 0.462, P < .05). The multivariate logistic regression analysis showed that TTE-LAWV < 8.7 cm/s was an independent predictor of LAA thrombus formation (odds ratio, 9.473; 95% confidence interval, 1.172-76.55; P < .05).

Conclusion: TTE-LAWV can noninvasively evaluate LAA dysfunction and assist in the detection of LAA thrombus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrial Appendage / diagnostic imaging*
  • Atrial Fibrillation / diagnostic imaging*
  • Atrial Fibrillation / etiology*
  • Echocardiography / methods*
  • Female
  • Humans
  • Male
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Thrombosis / complications*
  • Thrombosis / diagnostic imaging*