Abstract 12289: Left Atrial Appendage Wall Velocity Measured by Transthoracic Echocardiography is a Feasible Marker for Predicting Poor Prognosis in Patients with Cardioembolic Stroke
It is important to evaluate left atrial appendage (LAA) dysfunction for primary and secondary prevention of stroke in patients with atrial fibrillation. We and others previously reported that LAA dysfunction could be evaluated by LAA wall velocity (LAWV) measured by transthoracic echocardiography (TTE). We aimed to examine whether TTE-LAWV can predict long-term cerebrovascular events in patients with cardioembolic stroke patients. We performed TTE and transesophageal echocardiography within 7 days after onset in 106 consecutive cardioembolic stroke patients (65 males, mean age 73 ± 12 years) 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 26 cerebrovascular events during a median follow-up of 444 days. TTE-LAWV was significantly lower in patients with cerebrovascular events than in patients without events (10.8 ± 4.4 vs. 7.5 ± 1.6 cm/s, p<0.01). The Cox multivariate proportional hazard analysis showed that low TTE-LAWV was an independent predictor of cerebrovascular events (per 1SD decrease, hazard ratio, 1.264 (per 1SD decrease), p<0.01). Kaplan-Meier analysis showed that cerebrovascular event rates were significantly higher in patients with low TTE-LAWV (<8.7 cm/s) compared to those with high TTE-LAWV (38% vs. 10%, p<0.01). In conclusion, the impairment of LAA function was associated with the long-term cerebrovascular events in patients with cardioembolic stroke. TTE-LAWV may be a feasible parameter for risk stratification in cardioembolic stroke patients.
- © 2011 by American Heart Association, Inc.