학술대회 안내 사전등록 안내 초록등록 안내 초록등록/관리 숙박및교통 안내


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Is left atrial appendage function assessed by volumetric method on transesophageal echocardiography useful as a risk factor for thromboembolism?
가천의과대학교 길병원 심장센터 심장내과
최경림, 정욱진, 신미승, 오규진, 고광곤, 안태훈, 최인석, 신익균
Purpose: The left atrial (LA) appendage is a common source of cardiac thrombus formation associated with systemic embolism. And LA appendage dysfunction assessed by Doppler profile has been associated with spontaneous echocardiographic contrast, thrombus formation and thromboembolism. But there were not so many reports about the role of LA appendage dysfunction assesed by volumetric method on the occurrence of systemic embolism. Methods: Fourty one consecutive patients who was referred to transesophageal echocardiography were enrolled. We assessed LA appendage function including volumetric method and peak emptying and filling velocity. And TEE Data was analyzed by combining with clinical and transthoracic echocardiographic data. Data are expressed as means ± standard error of mean. Results: Among participants (41.5% male, mean age 59.5±2.1 years), 16 patients (39.0%) had newly diagnosed cerebral or cerebellar infarction and 8 patients (19.5%) and 16 patients (39.0%) showed thrombi and moderate to severe swirling in LA or LA appendage, respectively. Lower LA appendage peak emptying velocity, lower left ventricular ejection fraction and larger LA appendage end systolic volume were significantly related to newly diagnosed cerebral or cerebellar infarction (p=0.034, p=0.041 and p=0.047, respectively). And presence of atrial fibrillation, lower LA appendage peak filling velocity and larger LA appendage end diastolic volume were significantly related to thrombi or moderate to severe swirling in left atrial and LA appendage (p=0.004, p=0.015 and p=0.047, respectively). By multivariate analysis, the patients with thrombi or moderate to severe swirling in LA or LA appendage showed significantly lower LA appendage peak filling velocity (p=0.019). Conclusions: LA appendage function assessed by volumetric method on TEE is as useful as Doppler profile to stratify a risk for thromboembolism. Assessment of LA appendage function assessed by both volumetric method and Doppler profile may be considered as an integral part of the rountine clinical TEE examination.


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