The predictive value of two-dimensional speckle tracking technology combined with real-time three-dimensional echocardiography for left atrial appendage thrombosis in patients with non-valvular atrial fibrillation
MU Ting-ting
DENG Ai-yun
WANG Xiao-juan
MA Hang-yu
Qi Liang
Abstract：Objective To explore the value of two-dimensional speckle tracking technology(2D-STE)combined with real-time three-dimensional echocardiography(RT-3DE)parameters in predicting left atrial appendage thrombosis(LAAT)formation in patients with non-valvular atrial fibrillation(NVAF).Method A total of 20 patients with LAAT detected by transesophageal echocardiography at the First Hospital of Lanzhou University from January 2023 to August 2023 were as LAAT group,and 52 patients without detected LAAT as the non LAAT group.The two-dimensional and three-dimensional echocardiography parameters and baseline data of the patients were collected,and the differences between the data of the two groups were compared.Logistic regression was used to analyze the influencing factors of LAAT in patients with NVAF,and Pearson linear correlation analysis was utilized to analyze the correlation between left atrial sphericity index(LASI)and left atrial volume index(LAVI);and receiver operating characteristic(ROC)curves was drawn to analyze the diagnostic efficacy of echocardiography parameters for thrombosis in NVAF patients.Result Compared with the control group,N-terminal B-type natriuretic peptide(NT-proBNP)levels were increased in the LAAT group[1437.50(650.50,2247.50)ng/ml vs.788.58(158.50,1242.50)ng/ml],and the difference was statistically significant(P<0.05).The left atrial anterior posterior diameter,upper and lower diameters,left and right diameters,LASI,maximum left atrial volume(LAV),and LAVI were increased in the LAAT group compared to the control group[(43.15±6.01)mm vs.(38.24±5.67)mm,(62.68±5.58)mm vs.(57.77±5.71)mm,(45.72±5.36)mm vs.(40.43±5.47)mm,(77.30±7.06)%vs.(69.71±6.24)%,(104.31±28.05)ml vs.(75.83±23.40)ml,(57.44±15.30)mm vs.(41.12±12.40)].The left ventricular ejection fraction(LVEF)and peak left atrial longitudinal strain(PALS)were decreased in the LAAT group compared to the control group[(54.16±6.30)%vs.(59.73±5.10)%,8.75(7.33,12.50)]%vs.15.80(10.73,21.78)%],and the differences were statistically significant(P<0.05).Logistic regression analysis showed that LAVI,LASI,and PALS were independently correlated with LAAT in NVAF patients.Pearson linear correlation analysis showed a positive correlation between LASI and LAVI(r=0.399,P=0.001).The ROC curve showed that the area under the curve(AUC)for predicting LAAT by LASI,LAVI,and PALS were 0.788(95%CI 0.666-0.911,P<0.01),0.796(95%CI 0.684-0.908,P<0.01)and 0.808(95%CI 0.698-0.919,P<0.01)respectively.The optimal cutoff values were 76.10%and 53.92 ml/m²、9.85%.When combined predicting LAAT,the AUC was 0.861(95%CI 0.761-0.960,P<0.05),the specificity was 85.0%,and the sensitivity was 75.0%.Conclusion LAVI,LASI and PALS are the independent predictors of LAAT in patients with NVAF.2D-STE combined with RT-3DE can be used as an economical,convenient and non-invasive tool,which is more helpful for detecting LAAT in NVAF patients.
Keywords：EchocardiographyNon valvular atrial fibrillationLeft atrial appendage thrombosis
Publication Date：2024-01-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 84-90 )