title: Clinical implications of left atrial appendage flow patterns in nonrheumatic atrial fibrillation.
abstract: Left atrial appendage (LAA) function and flow patterns in 29 patients with chronic nonrheumatic atrial fibrillation were studied by transesophageal echocardiography. These 29 patients (16 men and 13 women; mean age, 63.8 years; range, 38 to 77 years) were classified into two groups according to different LAA flow patterns. Seventeen patients (group 1) had well-defined LAA emptying and filling Doppler flow signals, and the other 12 patients (group 2) had very low LAA flow signals. No significant differences were found in age, sex, mean duration of atrial fibrillation, left ventricular end diastolic dimension, and left ventricular ejection fraction between the two groups. However, group 2 patients had larger left atrial diameter (42.8 +/- 4.2 mm vs 36.6 +/- 8.8 mm; p < 0.05), lower LAA ejection fraction (26.4 +/- 15.2 percent vs 42.6 +/- 14.1 percent; p < 0.05), and lower LAA peak emptying velocity (0.13 +/- 0.03 m/s vs 0.36 +/- 0.16 m/s; p < 0.001). Higher incidence of LAA spontaneous echocardiographic contrast formation in group 2 patients (8/12 vs 1/17; p < 0.001) was noted. In conclusion, a subset of patients with nonrheumatic atrial fibrillation were found to have lower LAA blood flow and poorer LAA function. These patients had higher incidence of left atrial or LAA spontaneous echo contrast formation which had been proved previously to be a marker for future systemic thromboembolism.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
authors.forename: Y H
authors.initials: YH
authors.lastname: Li
authors.forename: L P
authors.initials: LP
authors.lastname: Lai
authors.forename: K G
authors.initials: KG
authors.lastname: Shyu
authors.forename: J J
authors.initials: JJ
authors.lastname: Hwang
authors.forename: P
authors.initials: P
authors.lastname: Kuan
authors.forename: W P
authors.initials: WP
authors.lastname: Lien
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016279:Atrial Function, Left / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology; D003326:Coronary Circulation / Q000502:physiology*; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012307:Risk Factors; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology