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Estimation of left atrial blood stasis using diastolic late mitral annular velocity

Masaharu Masuda1, Katsuomi Iwakura, Koichi Inoue

  • 1Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka 530-0001, Japan. masuda101@cardiology.med.osaka-u.ac.jp

European Heart Journal. Cardiovascular Imaging
|November 10, 2012
PubMed

Insights

Diastolic late mitral annular velocity (a') measured by echocardiography can help identify left atrial (LA) blood stasis in patients with atrial fibrillation. Lower a' values indicate a higher risk of LA blood stasis.

Area of Science:

  • Cardiology
  • Echocardiography
  • Atrial Fibrillation Research

Background:

  • Diastolic late mitral annular velocity (a') assessed via transthoracic echocardiography (TTE) is linked to left atrial (LA) pump function and LA remodeling.
  • Investigating a' association with LA blood stasis is crucial for understanding atrial fibrillation pathophysiology.

Purpose of the Study:

  • To examine the relationship between a' and left atrial (LA) blood stasis in patients experiencing non-valvular paroxysmal atrial fibrillation.

Main Methods:

  • 138 patients with non-valvular paroxysmal atrial fibrillation in sinus rhythm underwent TTE and transesophageal echocardiography.
  • a' was measured using TTE; spontaneous echo contrast (SEC) and LA appendage flow velocity were assessed via transesophageal echocardiography.

Main Results:

  • 21% of patients exhibited spontaneous echo contrast (SEC).
  • The lowest quartile of a' (≤6.4 cm/s) showed significantly higher SEC rates and reduced LA appendage flow velocity.
  • A cut-off value of 7.0 cm/s for a' effectively predicted SEC (80% accuracy).
  • Decreased a' was independently associated with SEC (OR=0.61, P=0.0026).

Conclusions:

  • Reduced diastolic late mitral annular velocity (a') may serve as a valuable indicator for assessing left atrial (LA) blood stasis.
  • a' could aid in risk stratification for patients with paroxysmal atrial fibrillation.
Abstract

Keywords:
Blood stasisLeft atriumMitral annular velocitySpontaneous echo contrastThrombus

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