LEFT ATRIAL APPENDAGE CONTRACTION VELOCITY AS A PREDICTOR OF LEFT VENTRICULAR FUNCTION

Background: Left atrial appendage contraction velocity (LAAV) is used frequently as a surrogate for global left atrial function, but the validity of this parameter for the prediction of left ventricular systolic and diastolic function has not been evaluated extensively. The objective of this study was to assess the relationship between LAA contraction flow velocity and left ventricular systolic and diastolic function parameters.
Methods: This study was performed on 142 patients-62 male (43.5%) and 80 female (56.5%)- who were referred for an evaluation of the source of emboli. Exclusion criteria were significant valvular abnormality, prosthetic valve replacement and congenital-heart disease.
Results: The correlation between LAA contraction velocity and systolic ventricular function was significant (p value=0.05). There was an inverse. relation between LAA contraction velocity and LV contraction: in 78 patients with LVEF<50%, mean LAAV was about 29cm/s, while in 64 patients with LVEF>50%, mean LAAV was about 50cm/s. Regarding diastolic flow parameters and pulmonic vein flow, patients were classified into four groups as follows: 1) 76 cases with normal patterns, 2) 38 cases with impaired LV relaxation, 3) 16 cases with pseudo normalization and 4) 12 cases with restrictive patterns. Statistical analysis did not show significant correlation between LAAV and diastolic function (p=0.236). Correlation between diastolic function parameters and LAA contraction velocity revealed a significant relation between LAAV and A wave velocity of mitral inflow (p=0.02) and no significant relation between LAAV and other diastolic parameters including E wave velocity, DT and IVRT (p=0.66, p=0.73, p=0.79). ECG showed 98 cases with normal sinus rhythm (NSR), 9 with complete atrioventricular block (CAVB) and 35 with atrial fibrillation (AF). There was a significant reduction in LAAV in AF rhythm compared to NSR.
Conclusion: LAA contraction veBackground: Left atrial appendage contraction velocity (LAAV) is used frequently as a surrogate for global left atrial function, but the validity of this parameter for the prediction of left ventricular systolic and diastolic function has not been evaluated extensively. The objective of this study was to assess the relationship between LAA contraction flow velocity and left ventricular systolic and diastolic function parameters.
Methods: This study was performed on 142 patients-62 male (43.5%) and 80 female (56.5%)- who were referred for an evaluation of the source of emboli. Exclusion criteria were significant valvular abnormality, prosthetic valve replacement and congenital-heart disease.
Results: The correlation between LAA contraction velocity and systolic ventricular function was significant (p value=0.05). There was an inverse. relation between LAA contraction velocity and LV contraction: in 78 patients with LVEF<50%, mean LAAV was about 29cm/s, while in 64 patients with LVEF>50%, mean LAAV was about 50cm/s. Regarding diastolic flow parameters and pulmonic vein flow, patients were classified into four groups as follows: 1) 76 cases with normal patterns, 2) 38 cases with impaired LV relaxation, 3) 16 cases with pseudo normalization and 4) 12 cases with restrictive patterns. Statistical analysis did not show significant correlation between LAAV and diastolic function (p=0.236). Correlation between diastolic function parameters and LAA contraction velocity revealed a significant relation between LAAV and A wave velocity of mitral inflow (p=0.02) and no significant relation between LAAV and other diastolic parameters including E wave velocity, DT and IVRT (p=0.66, p=0.73, p=0.79). ECG showed 98 cases with normal sinus rhythm (NSR), 9 with complete atrioventricular block (CAVB) and 35 with atrial fibrillation (AF). There was a significant reduction in LAAV in AF rhythm compared to NSR.
Conclusion: LAA contraction velocity has a close relation with LV systolic function, but not diastolic function. Therefore, LAA contraction velocity should be considered a surrogate for left ventricular systolic function.