The connection between left atrial tissue Doppler imaging and stroke in patients with atrial fibrillation

Objective: The aim of this study was to analyze to what extent the left atrial (LA) pulse-wave tissue Doppler imaging (PWTDI) can provide additional information to the classical assessment, both in terms of quantifi-cation of AS function and its morphological changes, as well as in the estimation of thromboembolic risk, both in patients with score CHA2DS2-VASc of 0 and 1, where recommendations are less clear, but also in those with a score ≥2, where several parameters taken into account could help increasing the patient compliance to treatment and the physician’s decision regarding the complications of anticoagulation.

Methods: We have analyzed a number of 338 hospi-talized p. with non-valvular paroxysmal AF. The p. were examined after conversion to sinus rhythm using PWTDI, recording the 3 atrial functions (A1, A2, A3) and were followed by successive evaluations at 6 months. The primary end points were stroke and other peripheral embolism. All the patients were treated with oral anticoagulation therapy.

Results: Of the 338 patients, 34 – group A suffered peripheral embolism in the follow-up period and 304 – group B were not diagnosed with these pathologies. There were significant positive correlations between A1 wave and score CHA2DS2-VASc (r=0.42), A3 wave and CHA2DS2-VASc score (r=0.42), and significant negati-ve correlations between A2 wave and CHA2DS2-VASc score (r=-0.42). Group A had an average CHA2DS2-VASc risk score of 4.7, and group B a score equal to 3.2, the differences being highly statistically significant (p=0.005). Comparing the LA Doppler waves we found significant differences regarding the A1 (p=0.01), A2 (p=0.009) and A3 (p=0.01) wave.

Conclusions: PWTDI showed statistically significant differences regarding all three atrial functions in pati-ents with or without embolic events. Thus, AS dysfunc-tion, in addition to the dysfunction of the left ventricle, is emerging as a new major thromboembolic risk factor in AF patients.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)