TY - JOUR
T1 - Regional Disparities of Left Atrial Appendage Wall Contraction in Patients With Sinus Rhythm and Atrial Fibrillation
AU - Farese, Gerardo E
AU - Tayal, Bhupendar
AU - Stöbe, Stephan
AU - Laufs, Ulrich
AU - Hagendorff, Andreas
N1 - Copyright © 2019 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.
PY - 2019/6
Y1 - 2019/6
N2 - Background: Patients with atrial fibrillation (AF)exhibit impaired left atrial appendage (LAA)function. However, regional characteristics of LAA function in patients with AF are not defined. Methods: Consecutive patients (n = 1,195)undergoing transesophageal echocardiography at a university hospital were included. Patients were divided into three groups on the basis of their rhythm: sinus rhythm (SR), paroxysmal AF, and permanent or persistent AF. Regional LAA wall velocities were determined using color Doppler tissue imaging, placing regions of interest at the lateral and medial wall of the LAA. Results: Of the 1,182 patients ultimately included, 691 (59%)were in SR, 371 (32%)had permanent or persistent AF, and 120 (10%)had paroxysmal AF with SR at the time of transesophageal echocardiography. Both lateral and medial LAA wall velocities were lower in patients with AF in comparison with those in SR. Nearly 90% of patients in both groups of patients with AF exhibited a pattern of medial LAA wall velocity greater than lateral LAA wall velocity, in comparison with 20% of patients with SR. The odds ratio for the association of this LAA contraction pattern with AF was 22.14 (95% CI, 12.06–40.64; P <.001). The movement of lateral LAA wall velocity showed the highest correlation with LAA emptying velocity compared with the medial LAA wall (r = 0.67, P <.001). Conclusions: Lateral LAA wall velocity is higher than medial LAA wall velocity in patients in SR, which reverses in patients with AF. Assessment of LAA regional wall velocity using Doppler tissue imaging appears to be a promising approach to identify patients with paroxysmal AF.
AB - Background: Patients with atrial fibrillation (AF)exhibit impaired left atrial appendage (LAA)function. However, regional characteristics of LAA function in patients with AF are not defined. Methods: Consecutive patients (n = 1,195)undergoing transesophageal echocardiography at a university hospital were included. Patients were divided into three groups on the basis of their rhythm: sinus rhythm (SR), paroxysmal AF, and permanent or persistent AF. Regional LAA wall velocities were determined using color Doppler tissue imaging, placing regions of interest at the lateral and medial wall of the LAA. Results: Of the 1,182 patients ultimately included, 691 (59%)were in SR, 371 (32%)had permanent or persistent AF, and 120 (10%)had paroxysmal AF with SR at the time of transesophageal echocardiography. Both lateral and medial LAA wall velocities were lower in patients with AF in comparison with those in SR. Nearly 90% of patients in both groups of patients with AF exhibited a pattern of medial LAA wall velocity greater than lateral LAA wall velocity, in comparison with 20% of patients with SR. The odds ratio for the association of this LAA contraction pattern with AF was 22.14 (95% CI, 12.06–40.64; P <.001). The movement of lateral LAA wall velocity showed the highest correlation with LAA emptying velocity compared with the medial LAA wall (r = 0.67, P <.001). Conclusions: Lateral LAA wall velocity is higher than medial LAA wall velocity in patients in SR, which reverses in patients with AF. Assessment of LAA regional wall velocity using Doppler tissue imaging appears to be a promising approach to identify patients with paroxysmal AF.
KW - Atrial fibrillation
KW - Doppler tissue imaging
KW - Echocardiography
KW - Left atrial appendage
UR - http://www.scopus.com/inward/record.url?scp=85062730212&partnerID=8YFLogxK
U2 - 10.1016/j.echo.2019.01.016
DO - 10.1016/j.echo.2019.01.016
M3 - Journal article
C2 - 30904369
SN - 0894-7317
VL - 32
SP - 755
EP - 762
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 6
ER -