Related Experiment Videos
Pulsed Doppler characterization of left atrial appendage flow
1Cardiovascular Research Institute, University of California, San Francisco.
Summary
Left atrial appendage velocities measured by transesophageal echocardiography reveal distinct flow patterns during sinus rhythm versus atrial fibrillation. Atrial fibrillation significantly reduces flow velocities and is the primary predictor of spontaneous contrast, indicating thrombogenic risk.
Area of Science:
- Cardiology
- Echocardiography
- Vascular Physiology
Background:
- The left atrial (LA) appendage is a potential source of thrombi.
- LA appendage blood flow dynamics may indicate thrombogenic potential.
Purpose of the Study:
- To evaluate left atrial appendage velocities using pulsed Doppler during transesophageal echocardiography.
- To assess the influence of cardiac rhythm, mitral regurgitation, and spontaneous contrast on LA appendage flow.
Main Methods:
- Transesophageal echocardiography with pulsed Doppler was used in 109 patients.
- LA appendage flow velocities were analyzed in relation to sinus rhythm, atrial fibrillation, mitral regurgitation, and spontaneous contrast.
Main Results:
- Sinus rhythm showed distinct forward and retrograde LA appendage flow waves.
- Atrial fibrillation was associated with reduced and irregularly irregular LA appendage flows.
- Moderate to severe mitral regurgitation did not significantly alter LA appendage velocities in sinus rhythm.
- Atrial fibrillation, not spontaneous contrast, was the significant predictor of spontaneous contrast on multivariate analysis.
Conclusions:
- LA appendage velocities differ significantly between sinus rhythm and atrial fibrillation.
- Atrial fibrillation is a key determinant of altered LA appendage hemodynamics and is linked to spontaneous contrast formation.
- Transesophageal echocardiography assessment of LA appendage flow provides valuable insights into thrombogenic risk.