Comparison of left atrial and left atrial appendage mechanics in the risk stratification of stroke in patients with atrial fibrillation.

ABSTRACT:

Background

Left atrial (LA) and left atrial appendage (LAA) dysfunction has been demonstrated to contribute to atrial fibrillation (AF)-related stroke. However, usefulness of LA and LAA mechanics has not been fully compared. We sought to investigate the association of LA and LAA mechanics with stroke and to compare their diagnostic values in the risk stratification of stroke in patients with nonvalvular AF.

Methods

A total of 208 consecutive patients with AF (63.58?±?10.37?years, 63.9% male,57.7% persistent AF) who underwent echocardiography before catheter ablation were prospectively enrolled. Speckle-tracking was used to measure LA and LAA global longitudinal strain (GLS). LA and LAA mechanical dispersions (MD) were defined as the standard deviation (SD) of time to peak positive strain corrected by the R-R interval.

Results

Patients with prior stroke/ transient ischemic attack (TIA) (n?=?31) had significantly higher LA and LAA MD than those without (n?=?177) (11.56?±?4.38% vs. 8.43?±?3.44%, 15.15?±?5.46% vs. 10.94?±?4.40%, both P?ConclusionsHigher LA and LAA mechanical dispersion are independently associated with stroke/TIA in AF patients and had incremental values over clinical and conventional echocardiographic parameters. What's more, priorities of dispersion assessment are different depending on patients' LA size.

SUBMITTER: Mao Y 

PROVIDER: S-EPMC7797160 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature