A comparative study of left atrial appendage wall velocity (LAAWV) in
correlation to LV ejection fraction, LV global longitudinal strain
(GLS), E/e’, and NT pro-BNP in ischemic and non-ischemic heart failure.
Abstract
Background: Left atrial appendage (LAA) function assessment is
often overlooked in patients with heart failure and reduced ejection
fraction (HFrEF), regardless of its etiology (ischemic or non-ischemic
cardiomyopathy). With trans-thoracic tissue doppler echocardiographic
(TDE), we compared LAA wall velocity with the conventional
echocardiographic and biochemical parameters of heart failure by
evaluating LVEF, LV GLS, E/e’ and serum NT pro-BNP level.
Methods and Results: We evaluated 154 stable HFrEF patients
with LVEF ≤ 40%. The mean age was 55.71 ± 12.48 years, with 59.09%
being male and 40.91% female. Among them, 77.27% had dilated
cardiomyopathy (DCMP), and 22.72% had ischemic cardiomyopathy (ICMP).
The mean LVEF was 29.87 ± 5.8, LV GLS was -8.46 ± 2.74, mitral E/e’ was
13.33 ± 2.74, and LAA wall velocity was 14.26 ± 5.56. The mean NT
pro-BNP level was 980.51 ± 611.77. Correlation analysis showed that LAA
wall velocity significantly correlated with LVEF (r = 0.634, p
< 0.001), had an inverse correlation with LV GLS (r = -0.671,
p < 0.001), mitral E/e’ (r = -0.756, p < 0.001), and
NT pro-BNP (r = -0.659, p = 0.007). Conclusion: TDE LAA wall
velocity is a valuable and feasible method for evaluating HFrEF
patients. Lower LAA wall velocity is associated with reduced LVEF,
impaired LV GLS, elevated left ventricular filling pressure (E/e’), and
higher NT pro-BNP levels.