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Thromboembolic Risk in Atrial Fibrillation: Association between Left Atrium Mechanics and Risk Scores. A Study Based on 3D Wall‐Motion Tracking Technology
Author(s) -
Islas Fabián,
Olmos Carmen,
Vieira Catarina,
De Agustín José A.,
MarcosAlberca Pedro,
Saltijeral Adriana,
Almería Carlos,
Rodrigo José L.,
García Fernández Miguel A.,
Macaya Carlos,
Pérez de Isla Leopoldo
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12711
Subject(s) - atrial fibrillation , cardiology , medicine , ejection fraction , left atrium , atrium (architecture) , nuclear medicine , mathematics , heart failure
Background/Objectives Atrial fibrillation ( AF ) is the most common cardiac arrhythmia and is associated with a significantly high risk of stroke and systemic embolism. The aim of our study was to assess the association between left atrium ( LA ) mechanics measured by 3D wall‐motion tracking (3 DWMT ) technology and the most common thromboembolic risk scores ( CHADS 2, CHA 2 DS 2‐ VAS c). Methods A total of 101 consecutive patients with permanent AF referred were included. Conventional bidimensional (2D) LA parameters, and LA mechanics by means of 3 DWMT were studied. Association between LA 2D and 3 DWMT parameters and both risk scores was evaluated as well as its correlation with every component of the score individually. Results Mean age was 78 ± 10 years. Mean CHADS 2 was 2.7 ± 1.3 and mean CHA 2 DS 2‐ VAS c was 4.4 ± 1.7. Values of 2D and 3 DWTM LA parameters were: 2D area 26.4 ± 9.7 cm 2 , 2D volume index 49.4 ± 10.1 mL/m 2 , 3 DWMT left atrial emptying fraction ( LAEF ) 15.9 ± 8.4%, longitudinal strain 9.1 ± 4.5% and area strain 14.9 ± 8.8%. Linear regression analysis showed statistically significant correlation between LA longitudinal strain and LAEF with CHADS 2 and CHA 2 DS 2‐ VAS c scores. For each 10% variation in longitudinal strain, CHADS 2 and CHA 2 DS 2‐ VAS c scores change in 0.7 and 0.8 points, respectively. Conclusions Left atrial longitudinal strain and emptying fraction assessed by 3D WMT technology have correlation with both CHADS 2 and CHA 2 DS 2‐ VAS c scores. Each 10% of variation in longitudinal strain represents a 0.7 and 0.8 points change in those risk scores. LA mechanics evaluation might provide additional value to risk scores and could be considered to be a predictor of stroke in patients with AF .