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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.

Abstract：

BACKGROUND:The 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. METHODS:LAA 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. RESULTS:Multivariate 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. CONCLUSIONS:LAA 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).

journal_name

Cardiovasc Ultrasound

journal_title

Cardiovascular ultrasound

authors

Ono K,Iwama M,Kawasaki M,Tanaka R,Watanabe T,Onishi N,Warita S,Kojima T,Kato T,Goto Y,Arai M,Nishigaki K,Takemura G,Noda T,Watanabe S,Minatoguchi S

doi

10.1186/1476-7120-10-50

subject

Has Abstract

pub_date

2012-12-27 00:00:00

pages

50

issn

1476-7120

pii

1476-7120-10-50

journal_volume

10

pub_type

杂志文章

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