Transesophageal Echocardiographic Predictors of Stroke in Patients with Paroxysmal Atrial Fibrillation

Abstract

Objective The left atrial appendage  is the most source of thrombus formation in atrial fibrillation.The aim of this study was to find out left atrial appendage functions in patients with PAF with or without stroke.

Materials and Methods This study included74 paroxysmal atrial fibrillation patients who were performed transesophageal echocardiography for evaluation of stroke or who have suspicion doubt of atrial septal defect and patent foramen ovale. All patients had undergone 24 hours electrocardiography Holter recorder, 2 dimensional echocardiography, transesophageal echocardiography.

Results Thereare no differences between the groups for diabetes, hypertension, smoking, hyperlipidemia and creatinine levels. Patients with stroke group had lower left atrial appendagefilling velocity (26.8±5, 38.9±5) (p<0.001), had lower left atrial appendagecontraction velocity (30.8±6, 46.6±7) (p<0.001) and had bigger left atrial appendagearea (2.7±0.6, 2.4±0.4) (p=0.03) than without stroke group. Left atrial appendagecontraction velocity (p=0.013) and filling velocity (p=0.045) are the independent predictors of stroke.

Conclusion Our findings showed that stroke is associated with low filling velocity and low contraction velocity of left atrial appendage. Our findings suggest that this indices are independent predictors of stroke. If these results are confirmed in future studies, patients with paroxysmal atrial fibrillation without stroke and with low filling velocity and low contraction velocity of left atrial appendageshould receive more medical attention, to reduce unfavorable outcomes.

Keywords

• Atrial fibrillation,stroke,left atrial appendage

Paroksismal Atrial Fibrilasyonlu Hastalarda Strokun Transözefagial Ekokardiyografik Prediktörleri

Abstract

Amaç Atrial fibrilasyonda trombüs oluşumunun en sık olduğu yer sol atrial apendiksdir (SAA). Bu çalışmada amacımız paroksismal atrial fibrilasyonu (PAF) olup strok geçiren ve geçirmeyen hastalarda SAA fonksiyonlarını ortaya çıkarmaktı.

Gereç ve YöntemlerStrok nedeni ile veya atrial septal defekt, patent foramen ovale şüphesi ile transözefagial ekokardiyografi yapılan 74 hasta çalışmaya alındı. Tüm hastalara 24 saatlik EKG holter, 2 boyutlu ekokardiyografi ve trans özefagial ekokardiyografi uygulandı.

Bulgular İki grup arasında diyabet, hipertansiyon, sigara içimi ve kreatinin seviyesi açısında fark saptanmadı. Strok grubunda strok olmayan gruba göre daha düşük SAA dolum velositesi(26.8±5, 38.9±5) (p<0.001), daha düşük kontraksiyon velositesi (30.8±6, 46.6±7) (p<0.001) ve daha büyük SAA alanı (2.7±0.6, 2.4±0.4) (p=0.03) saptandı. SAA kontraksiyon velositesi (p=0.013) ve dolum velositesi (p=0.045) Stoke için bağımsız prediktörler olarak tespit edildi.

Sonuç Bulgularımız düşük SAA kontraksiyon velositesi ve düşük dolum velositesinin strok ile ilişkili olduğunu gösterdi. Bu indeksler strok oluşumunun bağımsız prediktörleri idi. Bu sonuçlar gelecekte yapılacak çalışmalarla desteklenirse, PAF’ı olup strok geçirmemiş hastalarda düşük SAA kontraksiyon ve dolum basıncı mevcutsa olumsuz sonuçları azaltmak için daha fazla medikal tedavi düşünülmelidir.

Keywords

• Atrial fibrilasyon,strok,sol atrial apendiks

References

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