title: Comparison between transesophageal echocardiography and transthoracic echocardiography with harmonic tissue imaging for left atrial appendage assessment.
abstract: BACKGROUND
  Transesophageal echocardiography (TEE) is the method of choice for evaluating both anatomy and function of left atrial appendage (LAA). In contrast, conventional transthoracic echocardiography (TTE) does not result in images of sufficient quality to explore LAA.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the potential role of TTE with harmonic frequency imaging (HFI) for assessing LAA normal anatomy and function.
  
  
  METHODS
  The study group comprised 25 patients, (9 men, 16 women, mean age 51 years, range 20-82). The TTE as sessment of LAA both in fundamental frequency imaging (FFI) and HFI was performed using the apical two-chamber view, the longitudinal two-chamber view was used for TEE assessment of LAA. According to image quality, images were categorized into three classes: A: good quality, B: sufficient quality, C: poor quality.
  
  
  RESULTS
  Transthoracic echocardiography conventional imaging allowed sufficient LAA visualization (class B) in only 5 of 25 patients (20%); the HFI resulted in adequate LAA visualization in 23 of 25 patients (92%). Images were of good quality (class A) in 18 of 23 patients and of sufficient quality (class B) in 5 of 23 patients. Transesophageal echocardiography achieved good quality images in 24 of 25 patients (96%). Average LAA maximum area determined by HFI and TEE was 3.46 +/-1.17 and 3.59 +/- 1.16 cm2, respectively; LAA minimum area was 1.81 +/- 0.98 and 1.77 +/- 0.97 cm2, respectively. Percent LAA area change was 51 +/- 16.5 and 50.9 +/- 16% with HFI and TEE, respectively. Statistical analysis showed no difference between the data obtained with the two methods.
  
  
  CONCLUSIONS
  The results suggest that HFI TNE may be a useful tool for the exploration of LAA.
authors.affiliation: Department of Cardiology, University of Messina, Italy. scipione2@interfree.it
authors.forename: Scipione
authors.initials: S
authors.lastname: Carerj
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Trifiró
authors.forename: Antonio
authors.initials: A
authors.lastname: Granata
authors.forename: Francesco
authors.initials: F
authors.lastname: Luzza
authors.forename: Francesco
authors.initials: F
authors.lastname: Arrigo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Oreto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020517:Atrial Appendage / Q000000981:diagnostic imaging*; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged