Monika Jankajova1, Lucia Kubikova2, Gabriel Valocik1, Peter Candik3, Peter Mitro1, Marian Kurecko1, Frantisek Sabol4, Adrian Kolesar4, Maria Kubikova5, Marianna Vachalcova1, Marianna Dvoroznakova1. 1. East-Slovak Institute of Cardiovascular Diseases and Medical Faculty of Safarik University, Department of Cardiology, Safarik University, Ondavska 8, 040 11, Kosice, Slovakia. 2. East-Slovak Institute of Cardiovascular Diseases and Medical Faculty of Safarik University, Department of Cardiology, Safarik University, Ondavska 8, 040 11, Kosice, Slovakia. lucia.kubikova@gmail.com. 3. East-Slovak Institute of Cardiovascular Diseases and Medical Faculty of Safarik University, Department of Anesthesiology and Intensive Medicine, Safarik University, Kosice, Slovakia. 4. East-Slovak Institute of Cardiovascular Diseases and Medical Faculty of Safarik University, Department of Cardiac Surgery, Safarik University, Kosice, Slovakia. 5. East-Slovak Institute of Cardiovascular Diseases and Medical Faculty of Safarik University, Department of Vascular Surgery, Safarik University, Kosice, Slovakia.
Abstract
BACKGROUND: The left atrial appendage (LAA) strain and strain rate have not yet been studied in the prediction of cardiac thromboembolism. Therefore, this study aimed to evaluate the significance of LAA strain and strain rate as assessed by speckle-tracking imaging in relation to documented thromboembolic events. METHODS: A group of 80 patients with a mean age of 65 years who were referred for electrical cardioversion of nonvalvular atrial fibrillation was retrospectively analyzed. Each patient underwent 2D transesophageal echocardiography (TEE). Velocity vector imaging (VVI)-derived LAA strain and strain rate in parallel with other conventional TEE predictors were analyzed in terms of their association with previous embolic stroke and peripheral embolization. RESULTS: By comparing the two groups of patients with (22/80) and without embolic events (58/80), patients with embolic events were older, had higher CHA2DS2-VASc scores, higher incidence of coronary artery disease and LAA thrombi, and worse LAA strain and strain rate. Moreover, patients without embolization more often used anticoagulants than patients with embolic events. After adjusting for the abovementioned embolic risk factors, only the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [double weight], diabetes mellitus, stroke [double weight], vascular disease, age from 65 to 74 years, sex category) score and the LAA strain rate remained as significant predictors of embolic events. CONCLUSION: The results of the study show that the VVI-derived LAA strain rate is a significant predictor of documented ischemic stroke and systemic thromboembolism in patients with nonvalvular atrial fibrillation. Its predictive power is similar to the predictive power of the CHA2DS2-VASc score.
BACKGROUND: The left atrial appendage (LAA) strain and strain rate have not yet been studied in the prediction of cardiac thromboembolism. Therefore, this study aimed to evaluate the significance of LAA strain and strain rate as assessed by speckle-tracking imaging in relation to documented thromboembolic events. METHODS: A group of 80 patients with a mean age of 65 years who were referred for electrical cardioversion of nonvalvular atrial fibrillation was retrospectively analyzed. Each patient underwent 2D transesophageal echocardiography (TEE). Velocity vector imaging (VVI)-derived LAA strain and strain rate in parallel with other conventional TEE predictors were analyzed in terms of their association with previous embolic stroke and peripheral embolization. RESULTS: By comparing the two groups of patients with (22/80) and without embolic events (58/80), patients with embolic events were older, had higher CHA2DS2-VASc scores, higher incidence of coronary artery disease and LAA thrombi, and worse LAA strain and strain rate. Moreover, patients without embolization more often used anticoagulants than patients with embolic events. After adjusting for the abovementioned embolic risk factors, only the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [double weight], diabetes mellitus, stroke [double weight], vascular disease, age from 65 to 74 years, sex category) score and the LAA strain rate remained as significant predictors of embolic events. CONCLUSION: The results of the study show that the VVI-derived LAA strain rate is a significant predictor of documented ischemic stroke and systemic thromboembolism in patients with nonvalvular atrial fibrillation. Its predictive power is similar to the predictive power of the CHA2DS2-VASc score.
Authors: Andrea Sonaglioni; Michele Lombardo; Gian Luigi Nicolosi; Gian Franco Gensini; Giuseppe Ambrosio Journal: Int J Cardiovasc Imaging Date: 2021-09-18 Impact factor: 2.316