Correlation between cardiac rhythm, left atrial appendage flow velocity, and CHA2DS2‐VASc score: Study based on transesophageal echocardiography and 2‐dimensional speckle tracking. Issue 2 (11th January 2017)

• Record Type: Journal Article
• Authors: Zuo, Kun; Sun, Lanlan; Yang, Xinchun; Lyu, Xiuzhang; Li, Kuibao
• Is Part Of: Clinical cardiology. Volume 40:Issue 2(2017)
• Page Start: 120
• Page End: 125
• Publication Date: 2017-01-11
• Subjects: atrial fibrillation -- stroke -- CHA2DS2‐VASc score -- cardiac rhythm -- left atrial appendage flow velocity -- strain -- transesophageal echocardiography -- two‐dimensional speckle tracking; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.22639
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract : Background: The CHA2 DS2 ‐VASc score is a classic predictor of stroke in patients with atrial fibrillation (AF). Decreased left atrial appendage flow velocity (LAA‐FV) reflects the blood stasis, and left atrial (LA) strain is a manifestation of atrial remodeling. This study aimed to explore the effects of AF rhythm and CHA2 DS2 ‐VASc score in the development of thrombogenesis and their potential correlation with LAA‐FV and LA strain. Hypothesis: AF rhythm and high CHA2 DS2 ‐VASc score correlate independently with decreased LAA‐FV, which can be predicted by LA strain. Methods: In 98 AF patients, LAA‐FV was measured by transesophageal echocardiography and LA strain was measured by transthoracic echocardiography. Results: LAA‐FV decreased sharply in the AF rhythm group (26.22 vs 61.87 mm/s; P < 0.001), and CHA2 DS2 ‐VASc score did not differ between the decreased and normal LAA‐FV groups in all patients ( P = 0.289). However, in sinus rhythm (SR), LAA‐FV was associated with CHA2 DS2 ‐VASc score (coefficient = −0.317, P = 0.013), and the CHA2 DS2 ‐VASc score differed between the normal and decreased LAA‐FV groups (2 [0–7] vs 3 [0–6], respectively; P = 0.038). Moreover, LA strain was a predictor of LAA‐FV in both AF rhythm and SR, whereas a peak positive systolic strain divided by LA volume index <0.744 predicted decreased LAA‐FV. Conclusions: AF rhythm caused a sharp decrease in LAA‐FV independent of CHA2 DS2 ‐VASc score. In SR, the CHA2 DS2 ‐VASc score correlated negatively with LAA‐FV. LA strain was a predictor of LAA‐FV in both SR and AF rhythm.