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  • Title: The value of left atrial strain and strain rate in predicting left atrial appendage stasis in patients with nonvalvular atrial fibrillation.
    Author: Zhu MR, Wang M, Ma XX, Zheng DY, Zhang YL.
    Journal: Cardiol J; 2018; 25(1):87-96. PubMed ID: 28612903.
    Abstract:
    BACKGROUND: This study aimed to investigate the value of left atrial (LA) strain and strain rate (S/SR) by transthoracic echocardiography (TTE) in predicting left atrial appendage (LAA) stasis, in order to find a way for LAA stasis screening which is easily performed in patients with nonvalvular atrial fibrillation (NVAF). METHODS: One hundred and thirty NVAF patients prepared for AF ablation were enrolled. TTE and transesophageal echocardiography (TEE) were performed in all patients. LA S/SR in each phase was analyzed off-line. LAA blood flow state and LAA function were assessed by using TEE. RESULTS: LA S/SRs during atrial reservoir phase (LA Sres/SRres) were significantly negatively cor-related with LAA spontaneous echo contrast (SEC) grade (r = -0.567 and -0.520, respectively; all p < 0.01), and positively correlated with LAA emptying fraction (r = 0.602 and 0.619, respectively; all p < 0.01) and with LAA peak emptying flow velocity (r = 0.623 and 0.642, respectively; all p < 0.01). The multivariate logistic regression analysis showed LA Sres to be the strongest independent predictor of LAA stasis, followed by LA volume index. LA Sres < 13% was recommended to predict LAA stasis with sensitivity of 90% and specificity of 74%. CONCLUSIONS: LA Sres by TTE can noninvasively predict LAA stasis and may be used as a screening tool to assist in the detection of LAA stasis in patients with NVAF. (Cardiol J 2018; 25, 1: 87-96).
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