Prognostic value of low left atrial appendage wall velocity in patients with ischemic stroke and atrial fibrillation
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Updated: May 25, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Harutoshi Tamura1, Tetsu Watanabe, Satoshi Nishiyama
1Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Insights
Left atrial appendage (LAA) dysfunction, assessed by transthoracic echocardiographic LAA wall velocity (TTE-LAWV), predicts long-term stroke risk in atrial fibrillation (AF) patients. Lower TTE-LAWV indicates a higher risk of future cerebrovascular events.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Background:
- Left atrial appendage (LAA) dysfunction is crucial for stroke prevention in atrial fibrillation (AF).
- Transthoracic echocardiography (TTE) can assess LAA function via LAA wall velocity (LAWV).
Purpose of the Study:
- To determine if TTE-LAWV predicts long-term cerebrovascular events in ischemic stroke patients with AF.
Main Methods:
- 179 AF patients with stroke underwent TTE and transesophageal echocardiography within 7 days of onset.
- TTE-LAWV was measured at the LAA tip using Doppler tissue imaging.
- Prospective follow-up was conducted to record cerebrovascular events.
Main Results:
- 32 cerebrovascular events occurred during follow-up (median 397 days).
- Patients with events had significantly lower TTE-LAWV (8.3 vs 11.3 cm/sec).
- Low TTE-LAWV (<8.7 cm/sec) independently predicted events (HR 3.460) and was linked to higher event rates (34% vs 7%).
Conclusions:
- Impaired LAA function, indicated by low TTE-LAWV, is associated with long-term cerebrovascular events in AF stroke patients.
- TTE-LAWV shows potential as a feasible tool for risk stratification in AF patients.
Background:
It is important to evaluate left atrial appendage (LAA) dysfunction for primary and secondary prevention of stroke in patients with atrial fibrillation (AF). LAA dysfunction can reportedly be evaluated by LAA wall velocity (LAWV) measured by transthoracic echocardiographic (TTE) imaging. The aim of this study was to examine whether TTE-LAWV can predict long-term cerebrovascular events in patients with ischemic stroke with AF.
Methods:
TTE imaging and transesophageal echocardiographic imaging were performed <7 days after onset in 179 consecutive patients with stroke with AF. TTE-LAWV was measured using Doppler tissue imaging at the LAA tip from the parasternal short-axis view on TTE imaging, as previously reported. All patients were followed up prospectively.
Results:
Cerebrovascular events were defined as cerebrovascular death and/or recurrent ischemic stroke requiring hospitalization. There were 32 cerebrovascular events during a median follow-up period of 397 days. TTE-LAWV was significantly lower in patients with cerebrovascular events than in patients without (8.3 ± 2.8 vs 11.3 ± 4.0 cm/sec, P < .01). Cox multivariate hazard analysis showed that low TTE-LAWV (<8.7 cm/sec) was an independent predictor of cerebrovascular events (hazard ratio, 3.460; P < .05). Kaplan-Meier analysis showed that cerebrovascular event rates were significantly higher in patients with low TTE-LAWV (<8.7 cm/sec) compared with those with high TTE-LAWV (34% vs 7%, P < .01).
Conclusions:
Impaired LAA function was associated with long-term cerebrovascular events in patients with stroke with AF. TTE-LAWV may be a feasible parameter for risk stratification in patients with AF.
