Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
J Am Soc Echocardiogr. 2010 May;23(5):545-552.e1. doi: 10.1016/j.echo.2010.02.006. Epub 2010 Mar 31.
Atrial fibrillation is associated with ischemic stroke because of thrombi that form within the left atrial appendage (LAA). The aim of this study was to develop a new parameter for LAA function that is easily performed using transthoracic echocardiography (TTE).
TTE and transesophageal echocardiography were performed in 106 patients with stroke. LAA wall motion velocity (TTE-LAWV) was measured using Doppler tissue imaging at the LAA tip.
TTE-LAWV was significantly lower in patients with atrial fibrillation and LAA thrombus than in those with atrial fibrillation and no LAA thrombus and in sinus rhythm (7.5 +/- 1.9 vs 10.0 +/- 3.4 and 13.8 +/- 5.7 cm/s, respectively, P < .05). TTE-LAWV was significantly correlated with LAA emptying flow velocity (R = 0.462, P < .05). The multivariate logistic regression analysis showed that TTE-LAWV < 8.7 cm/s was an independent predictor of LAA thrombus formation (odds ratio, 9.473; 95% confidence interval, 1.172-76.55; P < .05).
TTE-LAWV can noninvasively evaluate LAA dysfunction and assist in the detection of LAA thrombus.
由于左心耳（LAA）内形成血栓，房颤与缺血性中风有关。本研究旨在开发一种新的 LAA 功能参数，该参数可通过经胸超声心动图（TTE）轻松进行测量。
对 106 例中风患者进行 TTE 和经食管超声心动图检查。使用多普勒组织成像在 LAA 尖端测量 LAA 壁运动速度（TTE-LAWV）。
与无 LAA 血栓和窦性心律的房颤患者相比，房颤伴 LAA 血栓患者的 TTE-LAWV 明显降低（分别为 7.5 +/- 1.9、10.0 +/- 3.4 和 13.8 +/- 5.7 cm/s，P <.05）。TTE-LAWV 与 LAA 排空流速显著相关（R = 0.462，P <.05）。多变量逻辑回归分析显示，TTE-LAWV < 8.7 cm/s 是 LAA 血栓形成的独立预测因子（比值比，9.473；95%置信区间，1.172-76.55；P <.05）。
TTE-LAWV 可以无创评估 LAA 功能障碍，并有助于检测 LAA 血栓。
