Low Wall Velocity of Left Atrial Appendage Measured by Trans-Thoracic Echocardiography Predicts Thrombus Formation Caused by Atrial Appendage Dysfunction
Low Wall Velocity of Left Atrial Appendage Measured by Trans-Thoracic Echocardiography Predicts Thrombus Formation Caused by Atrial Appendage Dysfunction
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DOI：
10.1016/j.echo.2010.02.006
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发表时间：
2010-05-01
影响因子：
6.5
通讯作者：
Kubota, Isao
中科院分区：
文献类型：
--
作者：
Tamura, Harutoshi;Watanabe, Tetsu;Kubota, Isao
背景：心房颤动与缺血性中风有关，因为左心耳 (LAA) 内形成血栓。本研究的目的是开发一种新的左心耳功能参数，该参数可通过经胸超声心动图 (TTE) 轻松执行。方法：对 106 名中风患者进行了 TTE 和经食管超声心动图检查。使用多普勒组织成像在 LAA 尖端测量 LAA 室壁运动速度 (TTE-LAWV)。 结果：房颤和 LAA 血栓患者的 TTE-LAWV 显着低于房颤且无 LAA 血栓的患者和窦性心律患者（分别为 7.5 +/- 1.9 vs 10.0 +/- 3.4 和 13.8 +/- 5.7 cm/s， P < .05)。 TTE-LAWV 与 LAA 排空流速显着相关（R = 0.462，P < .05）。多因素Logistic回归分析显示，TTE-LAWV < 8.7 cm/s是LAA血栓形成的独立预测因子（比值比，9.473；95%置信区间，1.172-76.55；P < .05）。结论：TTE-LAWV可以无创评估LAA功能障碍，协助发现LAA血栓。 （J Am Soc Echocardiogr 2010；23：545-52。）
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. (J Am Soc Echocardiogr 2010; 23: 545-52.)