Left Atrial Remodeling Assessed by Transthoracic Echocardiography Predicts Left Atrial Appendage Flow Velocity in Patients With Paroxysmal Atrial Fibrillation
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- Watanabe Atai
- Department of Advanced Medical Science, The Institute of Medical Science, The University of Tokyo
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- Suzuki Shinya
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Kano Hiroto
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Matsuno Syunsuke
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Takai Hideaki
- Department of Cardiovascular Surgery, The Cardiovascular Institute
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- Kato Yuko
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Otsuka Takayuki
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Uejima Tokuhisa
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Oikawa Yuji
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Nagashima Kazuyuki
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Kirigaya Hajime
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Kunihara Takashi
- Department of Cardiovascular Surgery, The Cardiovascular Institute
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- Sagara Koichi
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Yamashita Naohide
- Department of Advanced Medical Science, The Institute of Medical Science, The University of Tokyo
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- Sawada Hitoshi
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Aizawa Tadanori
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Yajima Junji
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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- Yamashita Takeshi
- Department of Cardiovascular Medicine, The Cardiovascular Institute
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抄録
Atrial fibrillation (AF) is associated with an increased risk of stroke and other thromboembolic events. Left atrial (LA) thrombus formation is closely related to LA dysfunction, particularly to decreased LA appendage flow velocity (LAA-FV) in patients with AF. We estimated LAA-FV using parameters noninvasively obtained by transthoracic echocardiography (TTE) in patients with paroxysmal AF.<br>Echocardiographic and clinical parameters were assessed in 190 patients with nonvalvular paroxysmal AF showing sinus heart rhythm during transesophageal echocardiography (TEE) and TTE.<br>LAA-FV (60 ± 22 cm/s) significantly correlated with the time interval between the initiation of the P-wave on ECG and that of the A-wave of transmitral flow on TTE (PA-TMF, correlation coefficient, −0.32; P < 0.001), LA dimension (LAD, −0.31; P < 0.001), septal a’ velocity of tissue Doppler imaging (TDI, 0.35; P < 0.001), E/e’ ratio (−0.28, P < 0.001), E velocity of transmitral flow (−0.20, P = 0.008), E/A ratio of transmitral flow (−0.18, P = 0.02), CHA2DS2-VASc score (−0.15, P = 0.04), and BNP plasma level (−0.32, P = 0.002). Multivariate analysis revealed that PA-TMF (standardized partial regression coefficient, −0.17; P = 0.03), a’ velocity (0.24, P = 0.004), and LAD (−0.20, P = 0.01) were independent predictors of LAA-FV (multiple correlation coefficient R, 0.44; P < 0.001).<br>Parameters of atrial remodeling, ie, decreased a’ velocity, increased LAD, and PA-TMF during sinus rhythm may be useful predictors of LA blood stasis in patients with nonvalvular PAF. LAA-FV can be estimated using these TTE parameters instead of TEE.
収録刊行物
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- International Heart Journal
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International Heart Journal 57 (2), 177-182, 2016
一般社団法人 インターナショナル・ハート・ジャーナル刊行会