Key result
Real-time three-dimensional transesophageal echocardiography effectively predicted left atrial appendage thrombosis, with LAA end-diastolic volume yielding an area under the curve of 0.896.
Why the study?
Can real-time three-dimensional transesophageal echocardiography (RT3D-TEE) parameters predict left atrial appendage thrombosis in patients with non-valvular atrial fibrillation?
Observational (n=94)
No
Can real-time three-dimensional transesophageal echocardiography (RT3D-TEE) parameters predict left atrial appendage thrombosis in patients with non-valvular atrial fibrillation?
Effect estimate: AUC 0.896 (95% CI 0.814-0.978)
p-value: p=<0.05
RT3D-TEE-derived left atrial appendage volumes and ejection fraction correlate with peak emptying velocity and can help predict LAA thrombosis in patients with non-valvular atrial fibrillation.
May aid LAA thrombosis risk stratification in non-valvular AF; hypothesis-generating and requires prospective validation before practice change.
The aim of the study was to examine changes in left atrial appendage volume (LAA-V) in patients with non-valvular atrial fibrillation (AF) using real-time three-dimensional transesophageal echocardiography (RT3D-TEE) and evaluate the prediction value on the high risk of thrombosis of LAA. Using RT3D-TEE we measured: i) LAA peak empty velocity (LAA-PEV), ii) LAA-V including LAA end-diastolic volume (LAA-EDV) and end-systolic volume (LAA-ESV). We also calculated LAA ejection fraction (LAA-EF). RT3D-TEE was applied in 20 control cases and 74 patients with non-valvular AF. According to the presence of thrombosis, 74 patients were divided into the no thrombosis group (NTH group, n=52) and thrombosis group (TH group, n=22). Our results showed that there were significant differences in LAA-V and LAA-EF values in different groups (P<0.05). LAA-EDV moderately correlated with LAA-PEV (r=-0.531, P<0.001) while LAA-ESV demonstrated a strong correlation with LAA-PEV (r=-0.741, P<0.001). LAA-EF also showed a strong correlation with LAA-PEV (r=0.693, P<0.001). Through receiver operating characteristic (ROC) curves, the cut-off values of LAA-EDV and LAA-ESV in thrombosis of LAA were 18.45 and 9.69 ml, respectively. RT3D-TEE effectively evaluated the LAA-V, LAA-PEV and LAA-EF parameters, and proved to be valuable in the process of evaluation of thrombosis of LAA.
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Gan et al. (2016) conducted an observational in Non-valvular atrial fibrillation (n=94). Real-time three-dimensional transesophageal echocardiography (RT3D-TEE) parameters vs. No thrombosis (NTH) group / Healthy controls was evaluated on Prediction of left atrial appendage thrombosis by LAA end-diastolic volume (LAA-EDV) (AUC 0.896, 95% CI 0.814-0.978, p=<0.05). Real-time three-dimensional transesophageal echocardiography effectively predicted left atrial appendage thrombosis, with LAA end-diastolic volume yielding an area under the curve of 0.896.
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