Left atrial strain: A new predictor of thrombotic risk and successful electrical cardioversion

被引：24

作者：

Costa C. ^{[1
,2
]}

González-Alujas T. ^{[1
]}

Valente F. ^{[1
]}

Aranda C. ^{[3
]}

Rodríguez-Palomares J. ^{[1
]}

Gutierrez L. ^{[1
]}

Maldonado G. ^{[1
]}

Galian L. ^{[1
]}

Teixidó G. ^{[1
]}

Evangelista A. ^{[1
]}

机构：

[1] Department of Cardiology, Hospital Vall D'Hebron, Barcelona

[2] Department of Cardiology, Hospital Santarém, Santarém

[3] Department of Cardiology, Hospital Infanta Cristina, Badajoz

来源：

Echo Research & Practice | 2016年 / 3卷 / 2期

关键词：

Atrial arrhythmias; Cardioversion; Echocardiography; Strain; Thrombotic risk;

D O I：

10.1530/ERP-16-0009

中图分类号：

学科分类号：

摘要：

Background: Left atrial deformation (LAD) parameters are new markers of atrial structural remodelling that seem to be affected in atrial fibrillation (AF) and atrial flutter (AFL). This study aimed to determine whether LAD can identify patients with a higher risk of thrombosis and unsuccessful electrical cardioversion (ECV). Methods: Retrospective study including 56 patients with AF or AFL undergoing ECV, with previous transthoracic (TTE) and transoesophageal echocardiography (TEE) studies. Echocardiographic parameters analysed were as follows: left ventricle function, left atrium (LA) dimensions, LAD parameters (positive and negative strain peaks), left atrial appendage (LAA) filling and emptying velocities and the presence of thrombi. Strain values were analysed according to thrombotic risk and success of ECV. Results: Lower mean values of peak-positive strain (PPS) in patients with prothrombotic velocities (<25 cm/s) and a higher incidence of thrombi in LAA were observed compared with those with normal velocities. Multivariate analysis revealed PPS normalised by LA maximum volume indexed by body surface area (BSA) to be associated with prothrombotic risk (odds ratio 0.000 (95% CI: 0.000'0.243), P 0.017), regardless of CHADs2VASC score. Peak-negative strain normalised by LA volumes indexed by BSA were associated with unsuccessful ECV. Conclusions: Atrial deformation parameters identify AF and AFL patients with a high risk of thrombosis and unsuccessful ECV. Therefore, these new parameters should be included in anticoagulation management and rhythm vs rate control strategies. © 2016 The authors.

引用

页码：45 / 52

页数：7

共 18 条

[1]

Ancona R., Pinto S., Caso P., D'Andrea A., Di Salvo G., Arenga F., Coppola M.G., Sellitto V., Macrino M., Calabro R., Left atrium by echocardiography in clinical practice: From conventional methods to new echocardiographic techniques, Scientific World Journal, 2014, (2014)

[2]

Shaikh A., Maan A., Khan U., Aurigemma G., Hill J., Kane J., Tighe D.A., Mick E., McManus D.D., Speckle echocardiographic left atrial strain and stiffness index as predictors of maintenance of sinus rhythm after cardioversion for atrial fibrillation: A prospective study, Cardiovascular Ultrasound, 10, (2012)

[3]

Yoon Y., Kim H., Kim S., Kim S., Park J., Park K., Choi S., Kim M.K., Kim H.S., Cho G.Y., Left atrial mechanical function and stiffness in patients with paroxysmal atrial fibrillation, Journal of Cardiovascular Ultrasound, 20, pp. 140-145, (2012)

[4]

Dell'Era G., Rondano E., Franchi E., Marino P., Atrial asynchrony and function before and after electrical cardioversion for persistent atrial fibrillation, European Journal of Echocardiography, 11, pp. 577-583, (2010)

[5]

Kaya E., Tokgozoglu L., Aytemir K., Kobacas U., Tulumen E., Deveci O., Kose S., Kabakci G., Nazli N., Ozkutlu H., Et al., Atrial myocardial deformation properties are temporarily reduced after cardioversion for atrial fibrillation and correlate well with left atrial appendage function, European Journal of Echocardiography, 9, pp. 472-477, (2008)

[6]

Zhang Q., Yip G., Yu C., Approaching regional left atrial function by tissue doppler velocity and strain imaging, Europace, 10, pp. iii62-iii69, (2008)

[7]

Di Salvo G., Caso P., Piccolo R., Fusco A., Martiniello A., Russo M., D'Onofrio A., Severino S., Calabro P., Pacileo G., Et al., Atrial myocardial deformation properties predict maintenance of sinus rhythm after external cardioversion of recent-onset lone atrial fibrillation: A color doppler myocardial imaging and transthoracic and transesophageal echocardiographic study, Circulation, 112, pp. 387-395, (2005)

[8]

Pagola J., Gonzalez-Alujas T., Flores A., Muchada M., Rodriguez-Luna D., Sero L., Rubiera M., Boned S., Ribo M., Alvarez-Sabin J., Et al., Left atria strain is a surrogate marker for detection of atrial fibrillation in cryptogenic strokes, Stroke, 45, pp. e164-e166, (2014)

[9]

Gasparovic H., Cikes M., Kopjar T., Hlupic L., Velagic V., Milicic D., Bijnens B., Colak Z., Biocina B., Atrial apoptosis and fibrosis adversely affect atrial conduit, reservoir and contractile functions, Interactive Cardiovascular and Thoracic Surgery, 19, pp. 223-230, (2014)

[10]

Esmaeilzadeh M., Vakilian F., Makeki M., Amin A., Taghavi S., Bakhshandeh H., Evaluation of left atrial two-dimensional strain in patients with systolic heart failure using velocity vector imaging, Archives of Cardiovascular Imaging, 1, pp. 51-57, (2013)

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