RESUMO
Objective:To investigate the association between abnormal left atrial appendage function and thrombotic events in patients with non-valvular atrial fibrillation, and the independent risk factors affecting left atrial appendage function.Methods:Patients with non-valvular atrial fibrillation, who visited the Atrial Fibrillation Center of the First Affiliated Hospital of Xinjiang Medical University from June 1, 2019 to June 1, 2021, were selected. According to left atrial appendage flow velocity (LAAFV), they were divided into normal left atrial appendage function group (297 patients with LAAFV ≥ 40 cm/s) and abnormal left atrial appendage function group (85 patients with LAAFV<40 cm/s). Baseline data and transesophageal echocardiography images were collected from all the patients. The occurrence of thrombotic events was recorded. Univariate and multivariate unconditional logistic regression analyses were conducted to investigate the correlation between abnormal left atrial appendage function and the occurrence of thrombotic events.Results:There were significant differences in gender, type of atrial fibrillation, CHA 2DS 2-VASc score, anticoagulant therapy, total cholesterol, low-density lipoprotein cholesterol, international normalized ratio (INR), left atrial diameter, proportion of patients with right atrial enlargement, left ventricular ejection fraction, inner diameter, sum of inner diameter, depth, and sum of depth of all angles of the left atrial appendage, and incidence of thrombotic events between the two groups (all P<0.05). After adjusting for confounders, multivariate unconditional logistic regression analyses showed that abnormal left atrial appendage function was closely associated with thrombotic events (β=1.168 P=0.002), and left atrial diameter ( OR=1.084, 95% CI 1.019-1.153, P=0.011) and persistent atrial fibrillation ( OR=2.323, 95% CI 1.226-4.403, P=0.010) were independent risk factors affecting left atrial appendage function. Conclusions:Abnormal left atrial appendage function is closely associated with thrombosis. The left atrial diameter and persistent atrial fibrillation were independent risk factors affecting left atrial appendage function.
RESUMO
The left atrial appendage is a long, tubular and trabecular structure and has a narrow junction with the left atrium. The left atrial appendage has been the focus of clinicians’ interests, because it is a potential site for the development of thrombus in several diseases. Aim: To study the correlation between mitral annular systolic velocity and left atrial appendage function in mitral stenosis. Methods: 60 patient with moderate to severe Mitral Stenosis with MVO <1.5 cm2 were included in the study. All eligible patients underwent a detailed history and clinical examination. A 12 lead electrocardiogram was taken. Echocardiographic evaluation was done for all patients Atrial fibrillation diagnosis was based on the electrocardiogram. Result: There was a positive correlation between these two variables which are statistically significant. (r=0.944, p-value<0.001). There was a positive correlation between left atrial appendage emptying velocity and mitral annular late diastolic velocity in patients in sinus rhythm. (r=0.695(p<0.001) The cut off value of peak annulus systolic velocity which is derived from the analysis of the receiver operator characteristic curve is 13.5cm/sec. The area under the curve is 0.840 with confidence interval 0.689 to 0.936 and the p-value<0.001. This value predicts inactive LAA (Laaev<25cm/sec) with a sensitivity of 92% and specificity of 96.5%. Conclusion: The systolic and diastolic annular velocities obtained by Doppler tissue imaging are reduced in patients with mitral stenosis. There is a positive correlation between annular systolic and left atrial appendage emptying velocities in mitral stenosis. The annular systolic velocity is an independent predictor for the presence of inactive left atrial appendage in mitral stenosis patients with sinus rhythm.