AUTHOR=Mao Yankai , Zhao Huajie , Yu Chan , Yang Yuan , Ma Mingming , Wang Yunhe , Jiang Ruhong , Zhao Bowen , Zheng Zhelan , Jiang Chenyang TITLE=Left Atrial Appendage Mechanical Dispersion Assessed by Speckle-Tracking Echocardiography as a Determinant of Left Atrial Appendage Blood Stasis in Patients With Atrial Fibrillation JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.905293 DOI=10.3389/fcvm.2022.905293 ISSN=2297-055X ABSTRACT=Aims

We sought to investigate the relationship of left atrial appendage (LAA) mechanical dispersion (MD) with LAA dense spontaneous echo contrast (SEC) or thrombus, and to compare its usefulness in the identification of thrombogenesis with left atrial (LA) MD or LA/LAA strain parameters in patients with atrial fibrillation (AF).

Methods

We conducted a cross-sectional study of 493 consecutive patients with AF [65(58.5–71.0) years, male 66.9%] who underwent echocardiography prior to catheter ablation. We measured the LAA and LA global longitudinal strain (GLS) using speckle-tracking echocardiography (STE). LAA MD and LA MD was defined as the standard deviation (SD) of time to peak positive strain corrected by the R-R interval.

Results

Patients with LAA dense SEC/thrombus (n = 70) had significantly higher LAA MD than controls (n = 423) [median 14.2(11.6–16.8)% vs 9.4(6.2–12.1)%, p < 0.01]. Multivariable analysis showed that LAA MD was independently associated with LAA dense SEC/thrombus in four different models (Odds ratio, 1.23–1.24; p < 0.01), and provided additional diagnostic value over clinical and standard echocardiographic parameters. Whereas, LA MD was not independently associated with LAA dense SEC/thrombus and had no incremental value over other LA/LAA mechanical parameters.

Conclusion

LAA mechanical dispersion was an independent determinant of LAA dense SEC/thrombus in AF patients, incremental to conventional risk factors and superior to LA mechanical dispersion.