Predicting a decrease in left atrial appendage flow velocity using left atrial diameter and CHA₂DS₂-VASc score in...

Area of Science:

• Cardiology
• Medical Imaging
• Thrombosis Research

Background:

• Left atrial appendage flow velocity (LAAFV) is an invasive predictor of thromboembolic events in atrial fibrillation (AF).
• Non-valvular AF (NVAF) patients require accessible, non-invasive risk stratification tools.
• Left atrial diameter (LAD) and CHA2DS2-VASc score are readily available clinical parameters.

Purpose of the Study:

• To evaluate the utility of combining LAD and CHA2DS2-VASc score for predicting decreased LAAFV in NVAF patients.
• To establish a novel, non-invasive score for assessing LAAFV reduction.
• To identify independent predictors of diminished LAAFV in NVAF.

Main Methods:

• Transesophageal echocardiography was performed on 716 consecutive NVAF patients.
• Patients were stratified into decreased LAAFV (<0.4 m/s) and preserved LAAFV (≥0.4 m/s) groups.
• Multivariate regression analyses identified predictors of LAAFV and its decrease.

Main Results:

• The decreased LAAFV group exhibited significantly larger LAD and higher CHA2DS2-VASc scores.
• LAD, CHA2DS2-VASc score, persistent AF, and BNP concentration were independently associated with decreased LAAFV.
• The novel LAD combined with CHA2DS2-VASc score demonstrated good predictive accuracy (AUC 0.733) for decreased LAAFV.

Conclusions:

• Enlarged LAD is an independent risk factor for reduced LAAFV in NVAF.
• Combining LAD with the CHA2DS2-VASc score significantly enhances the prediction of decreased LAAFV in NVAF patients.
• This novel score offers a valuable, non-invasive tool for risk stratification in NVAF.