Motion of left atrial appendage as a determinant of thrombus formation in patients with a low CHADS2 score receiving warfarin for persistent nonvalvular atrial fibrillation

Cardiovascular Ultrasound

Research

Masanori Kawasaki¹  Makoto Iwama¹  Shunichiro Warita¹  Toshiyuki Noda¹  Tai Kojima¹  Koji Ono¹  Takatomo Watanabe¹  Sachiro Watanabe¹  Yoshiaki Goto¹  Masazumi Arai¹  Kazuhiko Nishigaki¹  Noriyuki Onishi¹  Genzou Takemura¹  Shinya Minatoguchi¹  Ryuhei Tanaka¹  Takashi Kato¹ 

[1] Department of Cardiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu, Japan;

关键词: Atrial fibrillation;    Left atrial appendage;    Thrombus;    Transesophageal echocardiography;   

DOI  :  10.1186/1476-7120-10-50

 received in 2012-11-11, accepted in 2012-12-24,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to define the independent determinants of left atrial appendage (LAA) thrombus among various echocardiographic parameters measured by Velocity Vector Imaging (VVI) in patients with nonvalvular atrial fibrillation (AF) receiving warfarin, particularly in patients with a low CHADS2 score.MethodsLAA emptying fraction (EF) and LAA peak longitudinal strain were measured by VVI using transesophageal echocardiography in 260 consecutive patients with nonvalvular persistent AF receiving warfarin. The patients were divided into two groups according to the presence (n=43) or absence (n=217) of LAA thrombus. Moreover, the patients within each group were further divided into subgroups according to a CHADS2 score ≤1.ResultsMultivariate logistic regression analysis showed that LAAEF was an independent determinant of LAA thrombus in the subgroup of 140 with a low CHADS2 score. Receiver operating characteristics curve analysis showed that an LAAEF of 21% was the optimal cutoff value for predicting LAA thrombus.ConclusionsLAA thrombus formation depended on LAA contractility. AF patients with reduced LAA contractile fraction (LAAEF ≤21%) require strong anticoagulant therapy to avoid thromboembolic events regardless of a low CHADS2 score (≤1).

【 授权许可】

Unknown   
© Ono et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.