Echocardiography In The Assessment Of Left Atrial Appendage Function And Left Atrial Appendage Thrombus In Patients With Atrial Fibrillation

Objective: The study evaluated the function of the left atrial appendage and made the exploration of the independent risk factors about Spontaneous echo Contrast(SEC) and/ or left atrial appendage thrombus(LAAT) by transthoracic echocardiography(TTE) and transesophageal echocardiography(TTE) with tissue Doppler Imaging(TDI) for providing important clinical diagnosis and treatment value of the patients with paroxysmal atrial fibrillation and persistent atrial fibrillation.Method:1.The patients were divided into three group according to the clinical diagnosis, 100 patients with paroxysmal atrial fibrillation(A group), 84 patients with persistent atrial fibrillation(group B),another 20 normal sinus rhythm persons to sinus rhythm group(control group).Transthoracic echocardiography and transesophageal echocardiography with tissue Doppler technology to fully clear display of left atrial appendage and adjacent structures, recording atrial fibrillation patients and healthy sinus rhythm person of the age, left atrium diameter(LAD), left ventricular diameter(LVD), left atrial appendage orifice distance(LAA-D), left atrial appendage length(LAA-L), left atrial appendage maximum area(LAA-max), left atrial appendage minimum area(LAA-min), left ventricular ejection fraction(LVEF), left atrial appendage ejection fraction(LAA-EF), left atrial appendage peak flow emptying velocity(LAA-PEV), left atrial appendage peak filling velocity(LAA-PFV), the pulsed wave Doppler tissue doppler imaging(PW-TDI) S’in front, PW-TDI E’ in front, PW-TDI S ’after, PW-TDI E ’after of mitral annulus, comparing parameters such as mean and variance analysis and comparison of these three sets of data differences.2.The TEE for the diagnosis of atrial fibrillation patients would be divided into Group SEC and/or LAAT Patients and Group No abnormal, the differences of these two sets were stratified the multivariate Logistic Regression Analysis to explore the independent risk factors for the SEC and/or LAAT.Results:1.The results were those compared age, LAD, LVD, LAA-D, LAA-L, LAA-max, LAA-min is the SR group <paroxysmal AF group < persistent AF group, and LVEF, LAA-EF, LAA-PEV, LAA-PFV and the PW-TDI conclusion of the three groups : PW-TDI S ’ front, PW-TDI E’ front, PW-TDI S ’after, PW-TDI E ’after the results were compared, the sinus rhythm group> paroxysmal AF group> persistent AF group. Among the three groups in the parameters of age, in LAD, LAA-D, LAA-L, LAA-max, LAA-min, LAA-EF, LAA-PEV, LAA-PFV, PW-TDI S ’after,PW-TDI E ’after showed statistical significance(P <0.05).2.TEE examination revealed that the SEC and/or LAAT group had 60 cases. SEC were among 40 patients(16 males, 24 females), LAAT 20 patients(12 males and 8 females). Logistic regression analysis showed LAAEF(OR=1.119,95%CI:1.068~1.172), LAA-PFV(OR=1.092,95%CI:1.060~1.126), independent risk factor for the SEC and/or LAAT(P <0.05).Conclusion: Echocardiography could provide a sensitive indicator for the assessment of left atrial appendage function and thrombus.LAAEF and LAA-PFV were the strongest independent predictor of the SEC and/or LAAT which could predict atrial fibrillation thrombolic events may have significant value.