Author + information
- Erhan Saraçoğlu,
- Dilek Ural,
- Tayfun Şahin,
- Neslihan Özlem Al,
- Hakan Çakmak,
- Tayyar Akbulut,
- Kadriye Akay and
- Ertan Ural
The aim of this study was to investigate whether strain and strain rate (StR) values measured by 2-dimensional speckle tracking echocardiography are useful for the assessment of left atrial appendage (LAA) function.
Transesophageal echocardiography was performed in consecutive patients with sinus rhythm (n=82) and atrial fibrillation (n=43). After determination of LAA function with conventional methods, LAA was divided into 3 segments (medial, apical and lateral) and LAA longitudinal function was assessed by speckle tracking echocardiography. LAA late emptying velocity (LAAEV) was accepted as the gold standard for LAA function and normal LAA function was defined as LAAEV <50 cm/s.
Highest strain and StR values were measured in medial LAA wall in both sinus rhythm and AF patients (medial strain %19.2±6.8 vs. %7.4±3.4 and StrR 2.5±1.0 s-1 vs. 1.1±0.6 s-1, respectively). Segmental and global strain and StR values showed significantly good correlations with LAAEV and LAA emptying fraction. In ROC analysis, best cut-off values for global strain and StR to discriminate LAA function between sinus rhythm and AF, and also for normal and reduced LAA function were %11 and 1,4 s-1, respectively.
Strain and StR were significantly lower in patients with spontaneous echocardiographic contrast (SEC) when compared to those without (mean global strain: sinus rhtytm %17.8 vs. %7.9, p <0.001 and AF %7.5 vs. %5.9, p = 0.05, respectively). In logistic regression analysis, global strain was the best determinant of SEC (p<0.001). In ROC analysis, the cut-off global strain and StR values for the presence of SEC were similar, ≤%11.3 and ≤1,7 s-1, respectively.
Speckle tracking echocardiography is more specific and an unbiased diagnostic test for evaluating LAA functions in comparison with the mono-faceted procedures.