[Left Atrial Strain Independently and Incrementally Predicts High Risk Thromboembolic Findings Over CHA2DS2-VASc Score and BNP].

Koji Kurosawa, Kazuaki Negishi, Masaru Obokata, Hidemi Sorimachi, Kuniko Masuda, Tetsuo Machida, Masahiko Kurabayashi, Masami Murakami
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Abstract

Background: Left atrial longitudinal strain(LAs) is a novel and useful parameter of LA function and reflecting thromboembolic risk. CHA₂DS₂-VASc score and brain natriuretic protein (BNP) are also used for risk stratifica- tion. However, little is known about the impact of LAs on stroke risk stratification over these parameters. In this study, we aimed to examine whether LAs has independent and incremental risk stratification over them.

Methods: We studied 97 consecutive patients (age: 66 ± 12, 70 males) who underwent transesophageal echocardi- ography for evaluation of left atrial appendage (LAA) thrombus with persistent or paroxysmal atrial fibrillation. We assessed whether patients had spontaneous echo contrast (SEC) or not. Patients with LAA thrombus or sponta- neous echo contrast (SEC) were defined as high risk. LAs was assessed by averaging the segments measured in the 4- and 2-chamber views by transthoracic echocardiography.

Results: Among the 97 patients, 51(53%) patients had sinus rhythm and 36 were with SEC. Although LAs (21.0 ?9.0%), CHA₂DS₂-VASc score (2.7± 1.7) and BNP were mutually associated, only LAs and CHA₂DS₂-VASc score were independent predictors of high thromboembolic risk but BNP not. In nested logistic regression model anal- yses, predictive ability of a model with CHA₂DS₂-VASc score was improved by the addition of BNP (p =0.004) and further by adding LAs (p =0.027).

Conclusion: LAs predicts independently and incrementally LAA thrombus or SEC over CHA₂DS₂-VASc score and BNP, suggesting that LAs serves as a functional predictor for future thromboembolism. [Original].

左心房应变独立且增量地预测CHA2DS2-VASc评分和BNP的高风险血栓栓塞表现。
背景:左心房纵应变(LAs)是一种新的、有用的左心房纵应变功能参数,反映血栓栓塞风险。CHA₂DS₂- vasc评分和脑钠尿蛋白(BNP)也被用于危险分层。然而,在这些参数上,LAs对卒中风险分层的影响知之甚少。在这项研究中,我们旨在研究LAs是否具有独立的和递增的风险分层。方法:我们研究了97例连续患者(年龄:66±12,70名男性),他们接受了经食管超声心动图检查,以评估左心房附件(LAA)血栓伴持续性或阵发性心房颤动。我们评估患者是否有自发回声造影剂(SEC)。有LAA血栓或自发性回声造影(SEC)的患者被定义为高风险。通过经胸超声心动图对4室和2室视图中测量的节段进行平均来评估LAs。结果:97例患者中,51例(53%)有窦性心律,36例有SEC。虽然LAs(21.0%)、CHA₂DS₂-VASc评分(2.7±1.7)和BNP相互关联,但只有LAs和CHA₂DS₂-VASc评分是高血栓栓塞风险的独立预测因子,而BNP不是。在嵌套逻辑回归模型anal- yses中,添加BNP (p =0.004)和LAs (p =0.027)可提高CHA₂DS₂- vasc评分模型的预测能力。结论:LAs独立且增量地预测LAA血栓或SEC,而不是CHA₂DS₂-VASc评分和BNP,表明LAs可作为未来血栓栓塞的功能预测因子。(最初的)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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