Left Atrial Deformation Parameters Predict Left Atrial Appendage Function and Thrombus in Patients in Sinus Rhythm with Suspected Cardioembolic Stroke: A Speckle Tracking and Transesophageal Echocardiography Study

The aim of this study was to evaluate left atrial deformations using speckle tracking echocardiography for predicting left atrial appendage (LAA) thrombus in patients with suspected cardioembolic stroke who were in normal sinus rhythm. A total of 153 ischemic stroke patients (89 males, 64 females) i...

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Veröffentlicht in:Echocardiography (Mount Kisco, N.Y.) Jg. 30; H. 5; S. 572 - 581
Hauptverfasser: Karabay, Can Yücel, Zehir, Regayip, Güler, Ahmet, Oduncu, Vecih, Kalayci, Arzu, Aung, Soe Moe, Karagoz, Ali, Tanboga, Ibrahim Halil, Candan, Ozkan, Gecmen, Cetin, Erkol, Ayhan, Esen, Ali Metin, Kirma, Cevat
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Blackwell Publishing Ltd 01.05.2013
Schlagworte:
Adult
Atrial Appendage - diagnostic imaging
Atrial Appendage - physiopathology
Atrial Function, Left - physiology
cardioembolic stroke
Cohort Studies
Echocardiography, Doppler - methods
Echocardiography, Transesophageal - methods
Female
Heart Atria - diagnostic imaging
Heart Atria - physiopathology
Heart Diseases - complications
Heart Diseases - diagnostic imaging
Heart Diseases - physiopathology
Heart Rate - physiology
Humans
left atrial appendage function
left atrial deformation parameters
Logistic Models
Male
Middle Aged
Predictive Value of Tests
Prognosis
Prospective Studies
Risk Assessment
ROC Curve
speckle tracking echocardiography and transesophageal echocardiography study
Statistics, Nonparametric
Stroke - diagnostic imaging
Stroke - etiology
Stroke - physiopathology
Thrombosis - complications
Thrombosis - diagnostic imaging
Thrombosis - physiopathology
ISSN:0742-2822, 1540-8175, 1540-8175
Online-Zugang:Volltext
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Zusammenfassung:The aim of this study was to evaluate left atrial deformations using speckle tracking echocardiography for predicting left atrial appendage (LAA) thrombus in patients with suspected cardioembolic stroke who were in normal sinus rhythm. A total of 153 ischemic stroke patients (89 males, 64 females) in sinus rhythm who were suspected of having cardioembolism were included in the study. The patients underwent conventional two‐dimensional (2D) echocardiogram and 2D speckle tracking echocardiogram of the left atrium. Left atrial peak strain (LA‐4C‐RES) and left atrial precontraction strain (LA‐4C‐PUMP) were measured. Patients were divided into 2 groups according to the presence of thrombus in the LAA in transesophageal echocardiography. Both LA‐4C‐RES and LA‐4C‐PUMP values were found to be significantly lower in patients with LAA thrombus (11.8 ± 1.4% vs. 33 ± 12%, P < 0.001 and 5.8 ± 1.3% vs. 14.2 ± 5.3%, P < 0.001, respectively). A good inverse correlation was present between LA‐4C‐RES values and LAA morphologic parameters (with LAA area: r = −0.70, P < 0.001, with LAA length: r = −0.60, P < 0.001), and a good positive correlation was present with LAA emptying velocity with pulse Doppler (r = 0.74, P < 0.001). The area under the receiver‐operating characteristic curve of the LA‐4C‐RES was 0.94 (0.90–0.98, P < 0.001), for the LA‐4C‐PUMP, the area was 0.92 (0.87–0.96, P < 0.001) to predict LAA thrombus. Left atrial deformation parameters measured by 2D speckle tracking method was found to predict impaired LAA functions and the presence of LAA thrombus in ischemic stroke patients with suspected cardioembolism, but who are in sinus rhythm.
Bibliographie:istex:E183FCD5822E74D1515CF44E6B58425A5A056EB1
ark:/67375/WNG-CW3GFDG5-F
ArticleID:ECHO12089
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0742-2822
1540-8175
1540-8175
DOI:10.1111/echo.12089