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Effect of left ventricular diastolic dysfunction on left atrial appendage function and thrombotic potential in

Muhammed Bora Demirçelik1, Mustafa Çetin, Hülya Çiçekcioğlu

  • 1Deparment of Cardiology, Faculty of Medicine, Fatih University; Ankara-Turkey. drdemircelik@yahoo.com.

Anadolu Kardiyoloji Dergisi : AKD = the Anatolian Journal of Cardiology
|February 26, 2014
PubMed

Insights

Left ventricular diastolic dysfunction impairs left atrial appendage function in patients with nonvalvular atrial fibrillation. This dysfunction increases the risk of thrombus formation and stroke.

Area of Science:

  • Cardiology
  • Echocardiography

Background:

  • Nonvalvular atrial fibrillation (NVAF) is associated with increased risk of stroke.
  • Left atrial appendage (LAA) function plays a crucial role in preventing thrombus formation.
  • Left ventricular diastolic dysfunction (LVDD) is a commoncomorbidity in patients with NVAF.

Purpose of the Study:

  • To investigate the impact of LVDD on LAA function, spontaneous echo contrast (SEC), and thrombus formation in patients with NVAF.
  • To assess the relationship between LVDD and LAA hemodynamic parameters.

Main Methods:

  • Prospective study of 58 patients with chronic NVAF and preserved left ventricular systolic function.
  • Echocardiographic evaluation of LAA function, SEC grading, and LVDD.
  • Patients were divided into two groups: with LVDD (Group D, n=30) and without LVDD (Group N, n=28).
  • Statistical analysis included Pearson's chi-square, Fisher's exact test, and Spearman's correlation analysis.

Main Results:

  • Group D exhibited significantly higher peak pulmonary vein D velocity compared to Group N.
  • LAA emptying velocity, LAA lateral wall velocity, peak pulmonary vein S, and pulmonary vein S/D ratio were significantly lower in Group D.
  • A significant negative correlation was observed between SEC and LAA emptying/filling velocities, and pulmonary vein S/D and lateral wall velocities.
  • Reduced LAA function parameters were noted in patients with higher SEC grades (2-4) compared to SEC grade 1.

Conclusions:

  • LVDD is associated with impaired LAA function in patients with NVAF and preserved left ventricular ejection fraction.
  • LVDD may represent a significant risk factor for thrombus and stroke development in this patient population.
  • Echocardiographic assessment of LAA function in the context of LVDD is crucial for risk stratification in NVAF.
Abstract

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