Key result
Stage C HF and lower LAA velocity linked to ~109% higher LASEC odds in persistent AF.
Why the study?
Clinical and hemodynamic factors associated with general and dense left atrial spontaneous echo contrast in non-valvular persistent AF episodes lasting 90 days or more needed identification.
What clinical and hemodynamic factors are associated with left atrial spontaneous echo contrast in patients with late persistent atrial fibrillation?
Cross-Sectional (n=115)
What clinical and hemodynamic factors are associated with left atrial spontaneous echo contrast in patients with late persistent atrial fibrillation?
In patients with late persistent atrial fibrillation, heart failure stage C, pulmonary hypertension, and lower LAA flow velocity are associated with LASEC, while diabetes and lower LAA flow velocity are associated with dense LASEC.
Answers are grounded in this paper and cite their sources.
Should not yet change LASEC assessment in persistent AF; leaves open prospective validation of HF and LAA velocity links.
Objective The aim: To identify clinical and hemodynamic factors, associated with left atrial spontaneous echo contrast (LASEC) (LASEC in general, and the dense LASEC), in non-valvular persistent atrial fibrillation (AF) patients with the duration of AF episode ≥90 days. Patients and methods Materials and methods: The cross-sectional study consecutively enrolled 115 persistent AF patients with the duration of its episode ≥90 days (82 (71,3 %) males; mean age 59 ± 11 years). Transthoracic (TEE) and transesophageal echocardiography (TEE) were performed. LASEC (by TEE) was observed in 79 (68,7 %) patients. The dense (moder¬ate-to-severe) LASEC was detected in 23 (20,0 %) cases. Results Results: Heart failure (HF) stage C (OR 2,09 (95 % CI 1,24-3,53); p=0,006), lower TEE-derived left atrial appendage (LAA) flow velocity (FV) (OR 0,94 (95 % CI 0,91-0,98); p=0,003), and the presence of TTE-derived pulmonary hypertension (PH), appeared to be strongly associated with LASEC (AUC for logistic regression model: 0,83 [95 % СI 0,75- 0,89]). The presence of diabetes mellitus type 2 (DM) (OR 2,34 (95 % CI 1,13-4,86); p=0,027), along with lower LAA FV (OR 0,83 (95 % CI 0,76-0,91); p<0,001), were strongly associated with dense LASEC (AUC: 0,89 [95 % CI 0,82-0,94]). Conclusion Conclusions: The TEE-derived LASEC in patients with long term episodes (≥90 days) of persistent AF was strongly associated with HF stage C and TTE-derived PH, and with lower TEE-derived LAA FV. The presence of DM, in addition to lower LAA FV, was related to dense LASEC.
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Skybchyk et al. (2025) conducted a cross-sectional in Late persistent atrial fibrillation (n=115). Heart failure stage C (OR 2.09; 95% CI 1.24-3.53) and lower left atrial appendage flow velocity were strongly associated with left atrial spontaneous echo contrast in persistent atrial fibrillation.
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