Incremental value of left atrial mechanical dispersion over CHA₂DS₂‐VASc score in predicting risk of thrombus formation

Abstract

Left ventricular systolic dysfunction characterized by both LVEF and LVGLS is an independent factor for LAAT. LA asynchrony provides additional diagnostic value for discriminating between patients with and without LAAT.

Usefulness of transesophageal echocardiography before cardioversion in atrial arrhythmias

“…Kupczynska et al [28] have demonstrated the value of speckle-tracking analysis of the LA wall to identify patients with higher risk of thrombus. Additionally, both LVEF and global longitudinal turned out to be an independent risk factor for thrombus and provided additional diagnostic value for discriminating between patients with and without left atrial thrombus [29]. One of the most relevant and clinically important findings of the study is the relationship between cognitive dysfunction and thrombus (Figs.…”

Value of speckle tracking echocardiography for prediction of stroke risk in atrial fibrillation: Time to spare a stare outside the box?

“…It remains to be seen if the “appealing” biomarker in the form of LA strain and its dispersion can offer yet another opportunity to benefit patients with AF. Kupczynska et al have given us a compelling optimism in that direction, as we are lost in the vicious cycle of atrial myocardial disarray and atrial fibrosis that have inverse relationship with reservoir strain and are substrates for perpetuation of atrial fibrillation …”

“…In their excellent work published in this issue of the Journal, Kupczynska and colleagues investigated ninety‐three patients that were referred for routine transesophageal echocardiography for clinical indications such as direct current cardioversion for symptomatic and eligible subjects with AF. The investigators have not only studied absolute LA strain but also dispersion of LA strain with excellent reproducibility.…”

“…A British prospective study is in progress to address the matter. The mean heart rate in the LAAT group was higher in the study by Kupczynska et al . As heart rate was not entered into any statistical model, it is difficult to ascertain if it had also contributed to LAAT.…”

“…However, application of mechanical delay in LA contraction (expansion in reservoir strain) has been scant. In this regard, this study by Kupczynska et al, first of its kind, is a welcome relief. In their study, in the multivariate model, only LV global longitudinal strain (LV‐GLS) and LA asynchrony were retained as having significant association with LAAT.…”