Left Atrial Appendage Mechanical Dispersion Assessed by Speckle-Tracking Echocardiography as a Determinant of Left Atrial Appendage Blood Stasis in Patients With Atrial Fibrillation

Figures

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  FIGURE 1. LAA and LA strain curves from speckle-tracking in patients with LAA dense spontaneous echo contrast and thrombus (A,C) and controls (B,D). Yellow crosses indicate the positive peaks of each curve. Yellow arrows indicate the global peak longitudinal strain (GLS). Mechanical dispersion (MD) was defined as the SD of time to peak and expressed as a percentage of the R-R interval. LA, left atrium; LAA, left atrial appendage.

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  FIGURE 2. Receiver-operating characteristic curve analysis for identifying LAA dense spontaneous echo contrast or thrombus. AUC, area under the curve; GLS, global longitudinal strain; LA, left atrium; LAA, left atrial appendage; MD, mechanical dispersion.

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  FIGURE 3. Incremental values of LAA and LA mechanics for risk stratification of LAA dense spontaneous echo contrast or thrombus. The initial model was based on CHA2DS2-VASc score, LVEF, LAVImax and LAA FV. LA MD, LAGLS, LAA GLS, and LAA MD was sequentially added to the initial model in different order and the global χ2 value was compared. The parameter added in the last step was LAA MD (A), LAA GLS (B), LA MD (C), and LA GLS (D). The addition of LA MD provided no incremental value over other LA/LAA mechanical parameters. GLS, global longitudinal strain; LA, left atrium; LAA, left atrial appendage; LAAFV, LAA filling velocity; LAVI, LA volume index; LVEF, left ventricular ejection fraction; MD, mechanical dispersion.

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  FIGURE 4. The prevalence of LAA dense spontaneous echo contrast or thrombus according to LA/LAA mechanics and CHA2DS2-VASc score. GLS, global longitudinal strain; LA, left atrium; LAA, left atrial appendage; MD, mechanical dispersion.