Abstract 5127: Left Atrial Ejection Fraction (LAEF) is a Novel Marker of Left Atrial Appendage Dysfunction in Acute Stroke Patients

Abstract

Background Recently, it was reported that left atrial ejection fraction (LAEF) may be as a marker of left atrial dysfunction. However, the feasibility of LAEF remains to be determined. We investigated whether LAEF is a marker of left atrial appendage (LAA) dysfunction which causes cardiogenic embolism in stroke patients. Methods We performed trans-thoracic echocardiography (TTE) and trans-esophageal echocardiography (TEE) in 53 consecutive stroke patients (cardiogenic embolism, male/female=14/9, 70±12y; stroke of other sources, male/female =21/9, 66±16y). LAEF was calculated by the biplane area-length method from apical 4- and 2-chamber views at end systolic and diastolic phase. We compared LAEF to LAA peak emptying flow velocity which is an established marker of LAA dysfunction. Results LAEF was significantly lower in patients with cardiogenic embolism than in those without it (LAEF, 30.4±11.0 vs. 45.4±14.7, P<0.01). Left atrial dimensions, time and the ratio of the early diastolic trans-mitral inflow velocity (E wave), left atrial volume index (LAVI) and LAEF were significantly correlated with LAA emptying flow velocity. However, only LAEF was significantly correlated with LAA emptying flow velocity in patients with atrial fibrillation (R=0.566, p<0.05). Furthermore, the multivariate logistic regression analysis revealed that only LAEF was an independent predictor of LAA dysfunction in TTE parameters (odds ratio 3.96; 95% confidence interval 1.02–15.27; P<0.05). Conclusions LAEF may be a reliable non-invasive maker of LAA dysfunction and predict cardiogenic embolism in stroke patients.