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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.
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  • Abhijit Bharali,
  • Satyendra Tewari,
  • Harshit khare,
  • ANKIT SAHU,
  • Roopali Khanna,
  • Sudeep Kumar,
  • Naveen Garg,
  • Aditya Kapoor
Abhijit Bharali
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology

Corresponding Author:dr.abhijitbharali@gmail.com

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Satyendra Tewari
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Harshit khare
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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ANKIT SAHU
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Roopali Khanna
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Sudeep Kumar
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Naveen Garg
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Aditya Kapoor
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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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.