Key result
Patients with left atrial spontaneous echo contrast had significantly lower LAA velocity (16.8 vs 35.6 cm/sec, P<0.001) and reduced systolic PVF compared to those without SEC.
Cross-Sectional (n=36)
Low left atrial flow, indicated by low LAA flow velocity and reduced systolic PVF, is a major hemodynamic determinant for spontaneous echo contrast in nonrheumatic atrial fibrillation.
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Low LAA velocity and reduced systolic PVF may signal SEC in nonrheumatic AF; leaves open whether flow-targeted interventions alter thromboembolic risk.
This study analyzed the relation between frequency of left atrial appendage (LAA) contractions, pulmonary venous flow (PVF) parameters, and spontaneous echo contrast (SEC). Thirty-six patients (22 male, 14 female, mean age 61 plus minus 11 years) with nonrheumatic atrial fibrillation undergoing transesophageal echocardiography were studied. Doppler flow was obtained from both the LAA and the left upper pulmonary vein. Fourier analysis was applied to the LAA signal that exhibited the frequency of LAA contractions. LAA emptying velocity and PVF parameters were determined. There was no relation between velocity and frequency of LAA flow (r = 0.256, P = ns). Among LAA and PVF parameters, patients with left atrial SEC (n = 17) had a lower LAA velocity (16.8 +/- 10.8 cm/sec vs 35.6 +/- 13.2 cm/sec, P < 0.001), a larger LAA area (4.8 +/- 2.2 cm(2) vs 3.0 +/- 1.3 cm(2), P = 0.008), and a reduced systolic velocity time integral of PVF (3.4 +/- 2.2 cm vs 5.4 +/- 2.2 cm, P = 0.017) when compared with patients without SEC. Frequency of LAA contractions was similar between both groups (6.8 +/- 0.4 Hz vs 6.8 +/- 1.0 Hz, P = ns). In conclusion, the rate of LAA contraction does not correlate with LAA flow velocity and SEC. A low left atrial flow expressed by low LAA flow velocity and a reduction in systolic PVF is a major hemodynamic determinant for the occurrence of SEC.
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Bollmann et al. (2002) conducted a cross-sectional in Nonrheumatic atrial fibrillation (n=36). Left atrial spontaneous echo contrast (SEC) vs. Patients without SEC was evaluated on Left atrial appendage (LAA) velocity (p=<0.001). Patients with left atrial spontaneous echo contrast had significantly lower LAA velocity (16.8 vs 35.6 cm/sec, P<0.001) and reduced systolic PVF compared to those without SEC.
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