title: Effect of left ventricular diastolic dysfunction on left atrial appendage function and thrombotic potential in nonvalvular atrial fibrillation.
abstract: OBJECTIVE
  We aimed to investigate effects of left ventricular diastolic dysfunction on left atrial appendage functions, spontaneous echo contrast and thrombus formation in patients with nonvalvular atrial fibrillation.
  
  
  METHODS
  In 58 patients with chronic nonvalvular atrial fibrilation and preserved left ventricular systolic function, left atrial appendage functions, left atrial spontaneous echo contrast grading and left ventricular diastolic functions were evaluated using transthoracic and transoesophageal echocardiogram. Patients divided in two groups: Group D (n=30): Patients with diastolic dysfunction, Group N (n=28): Patients without diastolic dysfunction. Categorical variables in two groups were evaluated with Pearson's chi-square or Fisher's exact test. The significance of the lineer correlation between the degree of spontaneous echo contrast (SEC) and clinical measurements was evaluated with Spearman's correlation analysis.
  
  
  RESULTS
  Peak pulmonary vein D velocity of the Group D was significantly higher than the Group N (p=0.006). However, left atrial appendage emptying velocity, left atrial appendage lateral wall velocity, peak pulmonary vein S, pulmonary vein S/D ratio were found to be significantly lower in Group D (p=0.028, p<0.001, p<0.001; p<0.001). Statistically significant negative correlation was found between SEC in left atrium and left atrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities respectively (r=-0.438, r=-0.328, r=-0.233, r=-0.447). Left atrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities were significantly lower in SEC 2-3-4 than SEC 1 (p=0.003, p=0.029, p<0.001, p=0.002).
  
  
  CONCLUSIONS
  In patients with nonvalvular atrial fibrillation and preserved left ventricular ejection fraction, left atrial appendage functions are decreased in patients with left ventricular diastolic dysfunction. Left ventricular diastolic dysfunction may constitute a potential risk for formation of thrombus and stroke.
authors.affiliation: Deparment of Cardiology, Faculty of Medicine, Fatih University; Ankara-Turkey. drdemircelik@yahoo.com.
authors.forename: Muhammed Bora
authors.initials: MB
authors.lastname: Demirçelik
authors.forename: Mustafa
authors.initials: M
authors.lastname: Çetin
authors.forename: Hülya
authors.initials: H
authors.lastname: Çiçekcioğlu
authors.forename: Özgül
authors.initials: Ö
authors.lastname: Uçar
authors.forename: Mustafa
authors.initials: M
authors.lastname: Duran
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology*; D001783:Blood Flow Velocity; D003971:Diastole; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013927:Thrombosis / Q000150:complications / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*