Diagnostic value of transesophageal echocardiography on morphology and function of left atrial appendage in patients with unclosed foramen ovale complicated with atrial fibrillation.

BACKGROUND

This study investigates the diagnostic value of transesophageal echocardiography (TEE) for assessing the left atrial appendage (LAA) in patients with patent foramen ovale (PFO) and atrial fibrillation (AF). TEE provides detailed images that help evaluate the morphology and function of the LAA, which are crucial in diagnosing and managing these conditions.

METHODS

The study included 104 PFO patients admitted between December 2021 and January 2024, divided into AF (n = 53) and non-AF groups (n = 51). Additionally, 30 healthy individuals served as controls. All participants underwent TEE to compare ultrasound indices, LAA morphology, and function. The diagnostic values of these measurements were analyzed and compared across the three groups.

RESULTS

The AF group had a larger left atrial diameter (LAD) compared to the non-AF and control groups (P < 0.001). Both PFO groups had lower left ventricular ejection fractions (LVEF) than controls (P < 0.001), with the AF group showing lower LVEF than the non-AF group (P < 0.001). The AF group's LAA long diameter was greater (P < 0.05). LAA ejection fraction (LAAEF) and maximal emptying velocity (LAAPEV) were lower in PFO groups compared to controls, with the AF group also lower than the non-AF group (P < 0.01). Combined diagnostic measurements of LAA parameters showed higher accuracy (AUC = 0.979) than single measurements.

CONCLUSIONS

TEE evaluates LAA morphology and function effectively, providing significant diagnostic value for PFO with AF. Combined diagnostic parameters yield high specificity and sensitivity, enhancing diagnostic accuracy.