Tanta University, Egypt
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Background : Trans-esophageal echocardiogram (TEE) is a gold standard test for diagnosis of left atrial (LA) appendage function. Aim : To evaluate left atrial appendage (LAA) dysfunction using tissue Doppler mitral annular systolic velocity in acute embolic stroke young patients with sinus rhythm. Methods : Transthoracic (TTE) and transesophageal echocardiograhy (TEE) were performed in 70 consecutive patients with sinus rhythm without obvious left ventricular dysfunction within 2 weeks after embolic stroke. Two groups were identified: LAA dysfunction [LAA emptying peak flow velocity (LAA-eV) <0.55 m/s, n = 28, age 52 �?± 11 years] and without LAA dysfunction (LAA-eV â�?¥ 0.55 m/s, n = 42, age 54 �?± 10 years) on TEE. Tissue Doppler mitral annular systolic velocity was obtained in apical four chambers view on TTE and D-dimer level estimated for all patients. Results : Patients with LAA dysfunction (LAA-eV < 0.55)had significantly greater E/A ratio LAEF%, D-dimer and LAVI values compared to those without LAA dysfunction (LAA-eV â�?¥ 0.55). Sm was significantly lower in patients with than in those without LAA dysfunction ( P< 0.0001).There were no significant differences in Simpson LVEF% between patients with or without LAA dysfunction. There was a significant correlation between Sm, LAVI , LAEF%, E/A ratio and LAA- eV in all selected patients groups .The optimum cut-off value of Sm for predicting LAA dysfunction was determined by ROC curve analysis; Sm below or equal 8 cm/sec had a sensitivity of 89.6% and a specificity of 94.2% . Conclusion : Tissue Doppler mitral annular systolic velocity is an independent non â�?�?invasive easy predictor of LAA dysfunction and significantly correlated with LAA-eV ( p < 0.0001) . The optimal cut-off value for Sm < 8 cm/se (sensitivity 89.6 %, specificity 94.2 %) is a useful and convenient strong predictor of LAA dysfunction in acute embolic stroke young pateints with sinus rhythm.