Abstract 12932: Left Atrial Strain Evaluated by Two-Dimensional Speckle Tracking Predicts Left Atrial Appendage Dysfunction in Patients with Acute Ischemic Stroke
It is important to evaluate left atrial appendage (LAA) dysfunction for primary and secondary prevention of stroke in patients with atrial fibrillation (AF). It is well known that transesophageal echocardiography is useful for evaluating LAA function, but TEE is a semi-invasive procedure. Many clinical studies have shown a close relationship between LAA thrombus formation and left atrial (LA) mechanical remodeling. LA strain assessed by two-dimensional speckle tracking echocardiography is a new tool to evaluate LA function. However, the association of LA strain and LAA function remains to be fully determined. We performed transthoracic and transesophageal echocardiography in 60 consecutive patients with acute ischemic stroke within 7 days after onset (35 males, mean age 75 ± 11 years). Longitudinal LA strain was obtained using two-dimensional speckle tracking imaging at each LA segment (septum, lateral, posterior, anterior, and inferior), and peak systolic strain (S-LAs) was calculated by averaging the results for each segment. Thirty patients had LAA thrombus and/or severe LAA spontaneous echo contrast (LAA-SEC). S-LAs was significantly lower in patients with LAA thrombus and/or LAA-SEC than in those without (34.1 ± 12.7 vs. 11.1 ± 6.2 %, P<0.01). S-LAs was significantly correlated with LAA eV (r=0.541, p<0.01). The optimal cut off value of S-LAs for predicting LAA thrombus and/or LAA-SEC was determined for 21% (Figure). Multivariate logistic regression analysis showed that S-LAs < 21% was an independent predictor of LAA thrombus and/or LAA-SEC (odds ratio 105.3, 95% confidence interval 8.8-3802.3; p<0.01). In conclusion, decreased S-LAs was independently associated with LAA dysfunction and thrombus formation in patients with acute ischemic stroke.
- © 2012 by American Heart Association, Inc.