标题：Left atrial strain as evaluated by two-dimensional speckle tracking predicts left atrial appendage dysfunction in patients with acute ischemic stroke
摘要：Abstract Background Left atrial appendage (LAA) dysfunction predisposes patients with atrial fibrillation (AF) to cardioembolic stroke. Two-dimensional (2D) speckle tracking was reported to be useful for evaluating left atrial (LA) regional function, as well as left ventricular function. However, it remains unclear whether 2D speckle tracking is useful for evaluating {LAA} dysfunction. Therefore, we investigated whether decreased {LA} strain may predict {LAA} dysfunction and thrombus formation in patients with acute ischemic stroke. Methods We performed transthoracic and transesophageal echocardiography in 120 patients (83 males, mean age 72 ± 11 years) within 7 days of onset of an acute ischemic stroke. Longitudinal {LA} strain was evaluated using 2D speckle tracking imaging at each {LA} segment, and peak systolic strain was calculated by averaging the results for each segment. Results Forty-eight patients had {LAA} dysfunction as defined by the presence of {LAA} thrombus and/or severe spontaneous echo contrast. {LA} peak systolic strain was significantly decreased in patients with {LAA} dysfunction compared to those without (32.3 ± 13.7% vs. 12.1 ± 7.2%, p < 0.0001). {LA} peak systolic strain was significantly correlated with {LAA} emptying flow velocity (r = 0.693, p < 0.0001). The optimum {LA} peak systolic strain cut-off value for predicting {LAA} dysfunction was 19%. Multivariate logistic regression analysis showed that {LA} peak systolic strain was an independent predictor of {LAA} dysfunction (odds ratio 0.059, 95% confidence interval 0.018–0.146; p < 0.0001). Conclusion Decreased {LA} peak systolic strain was independently associated with {LAA} dysfunction in patients with acute ischemic stroke.
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