Abstract 10391: Low Wall Velocity of Left Atrial Appendage Measured by Transthoracic Echocardiography Predicts Long-Term Prognosis in Ischemic Stroke Patients With Atrial Fibrillation
It is important to evaluate left atrial appendage (LAA) dysfunction for primary and secondary prevention of stroke in patients with atrial fibrillation (AF). We and others previously reported that LAA dysfunction could be evaluated by LAA wall velocity (LAWV) measured by transthoracic echocardiography (TTE). The aim of this study was to examine whether TTE-LAWV can predict long-term cerebrovascular events in ischemic stroke patients with AF. We performed TTE and transesophageal echocardiography (TEE) within 7 days after onset in 179 consecutive stroke patients with AF referred to our department. TTE-LAWV was measured by Doppler tissue imaging at LAA tip from parasternal short axis view of TTE as previously reported. All patients were followed up prospectively. Cerebrovascular events were defined as cerebrovascular death and/or recurrent ischemic stroke requiring hospitalization. There were 32 cerebrovascular events during a median follow-up of 397 days. TTE-LAWV was significantly lower in patients with cerebrovascular events than in patients without events (8.3 ± 2.8 vs. 11.3 ± 4.0 cm/s, p<0.01). Cox multivariate hazard analysis showed that low TTE-LAWV (<8.7 cm/s) was an independent predictor of cerebrovascular events (hazard ratio, 3.110 (per 1 SD decrease), p<0.05). Kaplan-Meier analysis showed that cerebrovascular event rates were significantly higher in patients with low TTE-LAWV compared to those with high TTE-LAWV (34% vs. 7%, p<0.01). In conclusion, the impairment of LAA function was associated with the long-term cerebrovascular events in stroke patients with AF. TTE-LAWV may be a feasible parameter for risk stratification in patients with AF.
- © 2010 by American Heart Association, Inc.