Validation of transthoracic tissue Doppler assessment of left atrial appendage function

This study aimed to validate left atrial (LA) wall contraction velocity during atrial contraction (LAWV) in assessing LA function in 22 patients with paroxysmal atrial fibrillation. LAWV at the posterobasal LA wall was measured by transthoracic tissue Doppler echocardiography. LAWV was lower in patients with paroxysmal atrial fibrillation than in control subjects. It was more correlated with LA appendage velocity (r = 0.81) and fractional shortening (r = 0.85) than with parameters related to mitral inflow velocity or ring motion. With a LAWV cut-off value of 1.0 cm/s, receiver operator characteristic analysis curve showed a diagnostic sensitivity of 92% and a specificity of 80% in the identification of patients with spontaneous echocontrast. Among 8 patients with LAWV < or = 1.0 cm/s, cerebral embolism was evident in 3 and LA thrombus in 2, whereas the patients with LAWV greater than 1.0 cm/s had neither. LAWV may be useful to evaluate LA function and risk of embolism.