Global peak left atrial longitudinal strain assessed by transthoracic echocardiography is a good predictor of left atrial appendage thrombus in patients in sinus rhythm with heart failure and very low ejection fraction – an observational study

Table 1 Baseline characteristics of patients with and without LAAT confirmed on TEE

	All patients (n = 63)		With LAAT (n = 20, 31.7%)		Without LAAT (n = 43, 68.3%)		p-value
Age (years)	61.9	(±10.9)	62.8	(±9.9)	61.5	(±11.4)	0.67
Male sex	60	(95.2%)	20	(100%)	40	(93%)	0.57
Heart rate (bpm)	77.3	(±10.9)	76.0	(±10.8)	78.0	(±11.1)	0.51
BMI (kg/m²)	26.2	(±4.5)	26.1	(±4.7)	26.3	(±4.5)	0.83
BSA (m²)	1.9	(±0.2)	1.9	(±0.2)	1.9	(±0.2)	0.4
Ischaemic HF aetiology	33	(52.4%)	13	(65%)	20	(46.5%)	0.17
Hypertension	34	(54%)	11	(55%)	23	(53.5%)	0.91
Diabetes	21	(33.3%)	5	(25%)	16	(37.2%)	0,34
Chronic kidney disease	28	(44.4%)	9	(45%)	19	(44.2%)	0.95
History of stroke or TIA	7	(11.1%)	3	(15%)	4	(9.3%)	0.81
CHA₂DS₂-VASc score	3	(2–4)	3	(2–5)	3	(2–4)	0.65
NYHA class							0.59
I	0	(0%)	0	(0%)	0	(0%)
II	7	(11.1%)	3	(15%)	4	(9.3%)
III	34	(54%)	9	(45%)	25	(58.1%)
IV	22	(34.9%)	8	(40%)	14	(32.6%)
Aspirin	52	(82.5%)	17	(85%)	35	(81.4%)	0.99
Other antiplatelet agent	11	(17.5%)	6	(30%)	5	(11.6%)	0.15
Statin	39	(61.9%)	12	(60%)	27	(62.8%)	0.83
Diuretic	62	(98.4%)	19	(95%)	43	(100%)	0.69
Beta-blocker	58	(92.1%)	18	(90%)	40	(93%)	0.93
ACE-I or ARB	43	(68.3%)	16	(80%)	27	(62.8%)	0.17
MRA	53	(84.1%)	16	(80%)	37	(86.1%)	0.81
Calcium channel blocker	2	(3.2%)	0	(0%)	2	(4.7%)	0.84
Digoxin	2	(3.2%)	0	(0%)	2	(4,7%)	0.84
LA diameter (cm)	5.0	(±0.4)	5.0	(±0.3)	5.1	(±0.5)	0.6
LAA (cm²)	31.3	(±7.4)	31.1	(±5.5)	31.4	(±8.1)	1
LAVI (ml/m²)	62.1	(±13.3)	68.6	(±9.9)	59.1	(±13.7)	0.01
LVEF (%)	19.2	(±4.1)	18.9	(±5)	19.4	(±3.7)	0.99
E/A	2.4	(±1.1)	2.7	(±1.3)	2.3	(±1)	0.28
E/e`	24.2	(±8.4)	23.6	(±8.3)	24.5	(±8.5)	0.66
Global PALS (%)	8.9	(±2)	7.2	(±2.1)	9.7	(±1.3)	< 0.001
Global PACS (%)	−4.0	(±1.2)	−3.6	(±1.1)	−4.2	(±1.2)	0.04

Values are means (± standard deviations), median (interquartile range) or counts (%)
LAAT Left atrial appendage thrombus, TEE Transesophageal echocardiography, bpm Beats per minute, BMI Body mass index, BSA Body surface area, HF Heart failure, TIA Transient ischemic attack, NYHA New York Heart Association, ACE-I Angiotensin-converting-enzyme inhibitors, ARB Angiotensin receptor blockers, MRA Mineralocorticoid receptor antagonist, LA Left atrium, LAA LA area, LAVI LA volume index, LVEF Left ventricular ejection fraction, E/A The ratio of early to late transmitral diastolic velocities, e’ - pulsed-wave TDI-derived mitral annular early diastolic velocity, PALS Peak atrial longitudinal strain, PACS Peak atrial contraction strain

ISSN: 1476-7120