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

Guangyu Wang1, Guangyu Li1, Feng Hu1

  • 1Department of Cardiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, No.160 Pujian Road, Pudong New District, Shanghai, 200120, China.

BMC Cardiovascular Disorders
|April 4, 2023
PubMed
Summary

Left atrial diameter (LAD) combined with CHA2DS2-VASc score predicts reduced left atrial appendage flow velocity (LAAFV) in non-valvular atrial fibrillation (NVAF) patients. This non-invasive approach improves prediction of decreased LAAFV, aiding thromboembolic event risk assessment.

Keywords:
CHA2DS2-VASc scoreLeft atrial appendage flow velocityLeft atrial diameterNon-valvular atrial fibrillation

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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.