Estimation of left atrial appendage wall motion velocity in patients with persistent nonvalvular atrial fibrillation and its effect on thrombotic risk

• Main Authors: Waleed Yousof, Mahmoud Abdelghafar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Al-Azhar Assiut Medical Journal
• Subjects: atrial fibrillation; echocardiography; heart failure; left atrial appendage
• Online Access: http://www.azmj.eg.net/article.asp?issn=1687-1693;year=2021;volume=19;issue=2;spage=293;epage=303;aulast=Yousof

Background and aim Atrial fibrillation (AF) is the most common arrhythmia and accounts for one-third of hospitalizations for rhythm disorders in the United States. This increasing burden of AF leads to a higher incidence of stroke. Aim The aim of the study is to assess the risk of thrombogenesis in patients with persistent nonvalvular AF by using transthoracic echocardiogram, transesophageal echocardiogram, and tissue Doppler imaging in relation to the risk of thromboembolism (CHA2DS2-VAS score). Patients and methods Selected 50 patients with persistent AF were included. All patients underwent echocardiography assessment at the echocardiography unit. Results Regarding spontaneous echocardiography contrast, there was a statistically significant difference among the three groups. Regarding left atrial appendage (LAA) thrombus, there was a statistically significant difference among the three groups. Regarding left atial appendage flow velosity (LAAFV), there was an extremely statistically significant difference among the three groups. Regarding left atrial appendage wall velosity (LAAWV) by transthoracic echocardiogram, there was an extremely statistically significant difference among the three groups. Regarding LAAWV by transesophageal echocardiogram, there was an extremely statistically significant difference among the three groups. Conclusion Patients with clinical predictors of high risk included in the CHA2DS2-VASc score were associated with increased incidence of thrombus in the LAA. In patients with nonvalvular AF, the CHA2DS2-VASc score is recommended for assessment of stroke risk. There was a correlation between the development of thromboembolic events and high-risk CHA2DS2-VASc score, as high scores indicate increased thrombogenicity.