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Left atrial appendage dysfunction in acute embolic stroke young patients with sinus rhythm: Correlation with Tissue Doppler mitral annular systolic velocity

Artery Research volume 15, pages 12–18 (2016)Cite this article

Abstract

Background

Trans-esophageal echocardiogram (TEE) is a gold standard test for diagnosis of left atrial (LA) appendage function.

Aim

To evaluate left atrial appendage (LAA) dysfunction using mitral annular systolic velocity measured by tissue Doppler imaging “Sm” in acute embolic stroke young patients with sinus rhythm.

Methods

Transthoracic (TTE) and transesophageal echocardiography (TEE) were performed in 70 consecutive patients with sinus rhythm without obvious left ventricular dysfunction within 2 weeks after embolic stroke. Two groups were identified: LAA dysfunction [LAA emptying peak flow velocity (LAA-eV) <0.55 m/s, n = 28, age 52 ± 11 years] and without LAA dysfunction (LAA-eV ≥ 0.55 m/s, n = 42, age 54 ± 10 years) on TEE. Tissue Doppler mitral annular systolic velocity “Sm” was obtained in apical four chambers view on TTE and D-dimer level estimated for all patients.

Results

Sm was significantly lower in patients with than in those without LAA dysfunction (P < 0.0001). There was a significant correlation between Sm, LAVI, LAEF%, E/A ratio and LAA-eV in all selected patients groups. The optimum cut-off value of Sm for predicting LAA dysfunction was below or equal 8 cm/s (sensitivity 89.6% and specificity 94.2%).

Conclusion

Tissue Doppler mitral annular systolic velocity is an independent non-invasive easy predictor of LAA dysfunction and significantly correlated with LAA-eV (p < 0.0001) in acute embolic stroke young patients with sinus rhythm.

Abbreviations

Sm:

mitral annular systolic velocity

LAA:

left atrial appendage

LAA-ev:

left atrial appendage emptying velocity

TTE:

transthoracic echocardiography

TEE:

trans-esophageal echocardiography

LAD:

left atrial dimension

LVDd:

left ventricular end-diastolic dimension

LVEF:

left ventricular ejection fraction

E/E’:

the ratio of the early transmitral flow velocity and the early mitral annular velocity

LAVI:

left atrial volume index

LAEF:

left atrial emptying fraction

TDI:

tissue Doppler imaging;

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Authors and Affiliations

  1. Department of Cardiology, Tanta University, Egypt

    Rania Gaber & Mai Salama

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  1. Rania Gaber
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  2. Mai Salama
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Correspondence to Rania Gaber.

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Gaber, R., Salama, M. Left atrial appendage dysfunction in acute embolic stroke young patients with sinus rhythm: Correlation with Tissue Doppler mitral annular systolic velocity. Artery Res 15, 12–18 (2016). https://doi.org/10.1016/j.artres.2016.06.002

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Keywords

Artery Research

ISSN: 1876-4401

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