Left Atrial Strain as Evaluated by Two-Dimensional Speckle Tracking Predicts Left Atrial Appendage Dysfunction in Chinese Patients with Atrial Fibrillation
Table 1
Clinical characteristics of patients involved in this study.
All patients
LAA dysfunction
Normal LAA function
value
(n = 249)
(n = 120)
(n = 129)
Age (years)
59.7 ± 11.0
61.4 ± 9.7
58.1 ± 12.0
0.021
Gender (M/F)
181/68
92/28
89/40
0.174
Course of AF, months
43.6 ± 58.0
46.8 ± 62.2
40.5 ± 53.7
0.391
History of AF ablation
30 (12.0%)
15/105
15/114
0.833
INR
0.352
<2
217 (91.6%)
103 (89.6%)
114 (93.4%)
≥2
20 (8.4%)
12 (10.4%)
8 (6.6%)
Heart rhythm
<0.001
Atrial fibrillation, n (%)
128 (51.4%)
79 (65.8%)
42 (32.6%)
Sinus rhythm, n (%)
121 (48.6%)
41 (34.2%)
87v(67.4%)
Heart rate (bpm)
80.0 ± 23.7
83.6 ± 24.2
76.7 ± 22.9
0.006
Hypertension, n (%)
111 (44.6%)
55 (45.8%)
56 (43.4%)
0.701
Diabetes mellitus, n (%)
43 (17.3%)
22 (18.3%)
21 (16.3%)
0.668
Myocardiopathy, n (%)
6 (2.4%)
3 (2.5%)
3 (2.3%)
1.000
Coronary heart disease, n (%)
35 (14.1%)
16 (13.3%)
19 (14.7%)
0.752
CHA2DS2-VASc score
2.2 ± 1.7
2.4 ± 1.8
1.9 ± 1.5
0.031
Medications, n (%)
Antiplatelet drugs
28 (11.2%)
16 (13.3%)
12 (9.3%)
0.314
Anticoagulation drugs
77 (30.9%)
49 (40.8%)
28 (21.7%)
0.001
Antihypertension drugs
116 (46.6%)
59 (49.2%)
57 (44.2%)
0.431
Hypoglycemic agent
32 (12.9%)
16 (13.3%)
16 (12.4%)
0.827
Echocardiography
LAAeV, n (%)
<0.001
<40 cm/s
118 (47.4%)
118 (98.3%)
0 (0.0%)
≥40 cm/s
131 (52.6%)
2 (1.7%)
129 (100.0%)
LAT/SEC, n (%)
<0.001
Yes
43 (17.3%)
43 (35.8%)
0 (0.0%)
No
206 (82.7%)
77 (64.2%)
129 (100.0%)
LAD (mm)
39.4 ± 5.9
41.9 ± 4.7
37.0 ± 6.0
<0.001
LA transverse diameter (mm)
39.5 ± 6.1
42.0 ± 5.7
37.3 ± 5.5
<0.001
LA longitudinal diameter (mm)
48.0 ± 7.2
51.2 ± 6.6
45.0 ± 6.4
<0.001
LAVmax (ml)
50.5 ± 21.7
60.2 ± 22.9
41.6 ± 16.1
<0.001
LAVmin (ml)
31.5 ± 18.6
41.0 ± 19.7
22.8 ± 12.2
<0.001
LAEF (%)
40.5 ± 14.5
33.30 ± 11.75
47.14 ± 13.55
<0.001
LVEDD (mm)
46.2 ± 4.6
47.8 ± 4.5
44.8 ± 4.3
<0.001
LVESD (mm)
29.7 ± 4.7
31.3 ± 5.1
28.2 ± 3.8
<0.001
LVEDV (ml)
58.2 ± 18.8
63.3 ± 19.5
53.4 ± 16.8
<0.001
LVESV (ml)
26.7 ± 12.8
30.6 ± 14.3
23.1 ± 10.0
<0.001
Simpson LVEF (%)
63.0 ± 7.9
61.5 ± 8.7
64.5 ± 6.9
0.003
IVRT (ms)
84.8 ± 24.8
84.1 ± 23.5
85.4 ± 26.1
0.695
E/E′
11.1 ± 4.3
11.9 ± 4.7
10.5 ± 3.7
0.010
Peak strain of LA
26.0 ± 13.2
18.6 ± 8.9
33.0 ± 12.9
<0.001
LAA dysfunction is defined as the left atrial appendage emptying velocity <40 cm/s or left atrial appendage with thrombi/spontaneous echocardiographic contrast. Data are expressed as mean ± SD, number (percentage) of subjects, or median (interquartile range). CI, confidence interval; AF, atrial fibrillation; ACEI/ARB, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers; LAT/SEC, left atrial thrombi/spontaneous echo contrast; LAD, left atrial dimension; LVDd, left ventricular end-diastolic dimension; LVSd, left ventricular end-systolic dimension; LVDV, left ventricular end-diastolic volume; LVSV, left ventricular end-systolic volume; LVEF, left ventricular ejection fraction; E/E′, the ratio of the early transmitral flow velocity to the early mitral annular velocity; IVRT, isovolumic relaxation time; LAVmax, left atrial maximum volume; LAVmin, left atrial minimum volume; LAEF, left atrial emptying fraction; LAAeV, left atrial appendage emptying flow velocity.
