Potential value of left atrial appendage mechanics dispersion for
assessing LAA function in patients with Nov-valvular atrial fibrillation
Abstract
Background:Echocardiography is a clinical feasible method of choice for
the quantitative analysis of left atrial appendage (LAA) mechanics in
two dimensions. The study was to assess the potential relationship of
left atrial appendage (LAA) mechanics parameters and left atrial
appendage (LAA) function in patients with non-valvular atrial
fibrillation (NVAF) by two-dimensional transesophageal
echocardiography.Methods:This study involved 216 patients with Atrial
Fibrillation ( 39.4%,woman) who were referred for a clinical
indication for transesophageal echocardiography (TEE).Speckle-tracking
was used to measure left atrial appendage mechanics (LAA) myocardial
strain analysis. Left atrial appendage mechanical dispersions (LAAMD)
were defined as the standard deviation (SD) of time to peak positive
strain corrected by the R-R interval.Results:The Persistent atrial
fibrillation(per-AF)group were older, higher prevalence of stroke, and
more frequently suffered from heart failure than the Paroxysmal atrial
fibrillation(par-AF)group. The patients with a lower LAAEF had less
LAA mechanical dispersion than those with a higher LAAEF
(4.82(2.66~6.82) vs 8.31(5.22~11.85)
,p<0.05).The LAAMD had a significant positive correlation with the
LAAEF (r=0.455).The LAAEF and LAAMD having the diagnostic performance
(AUC,0.7397,95% CI 0.6692–0.8102, 0.6458, 95%CI 0.5678–0.7239,
respectively). Using a LAAEF cut-off value of <64.5% and LAA MD
cut-off value of <6.288%, patients with LAA dysfunction were
identified with a sensitivity of 70.45%, 62.96% and specificity of
68.47%, 60.55%, respectively.Conclusions:The data showed that LAAMD
was predictors of dysfunction of LAA, but LAAMD was not superior to
LAAEF in patients for predictors LAA dysfunction. However, Left atrial
appendage mechanical dispersion may showed decreased LAA function before
LAA deformation