P921 Left atrial appendage flow velocity (LAAV) and n-terminal pro brain natriuretic peptide (NT-proBNP) as strong predictors of high thromboembolic events in patients with nonvalvular atrial fibrillatio

Abstract

Abstract Background Many studies demonstrated that the presence of non valcular atrial fibrillation (NVAF) increased the risk of cardioembolic stroke from fivefold to sixfold. Cardioembolic stroke is commonly sourced by thrombi in Left Atrial Appendage (LAA) and since this is a treatable condition, early detection would be highly beneficial for a better prognosis. Aim : The aim of this study was to investigate the change of LAA flow felocity (LAAV) and its correlation with NT-proBNP plasma levels, Left atrial spontaneous echo contrast (LASEC) and CHA2DS2-Vasc score, as well as evaluating the prognostic value of these parameters in detecting thromboembolic events in patients with NVAF. Methods A non-interventional, cross-sectional observational study of 31 people with NVAF. Baseline patient characteristics, CHA2DS2-Vasc score, the five-grades of LASEC, NT-proBNP plasma levels were measured and LAAV visualized by transesophageal echocardiography (TEE) were performed. Results : LAAV were correlated with NT-proBNP (r = -0,511 , p = 0,003), high degree of SEC (r= -0,866 , p < 0,0001) and high CHA2DS2-VASc Score (p = 0.004). In addition, the receiver operating characteristic analysis revealed that the best cut-off value of NT-proBNP to predict higher risk of thromboembolic evants in patientswas 1052pg/mL with 76% sensitivity and 83.3% specificity (area under the curve: X2 = 7,441, p = 0.003). In the subgroup analysis based on different CHA2DS2-VASc scores, the predictive value of NT-proBNP remained significant in patients with a CHA2DS2-VASc score of ≥ 2. Conclusion LAAV were significanty correlated positively with NT-proBNP levels, degrees of SEC and CHA2DS2-VASc score. Plasma NT-proBNP along with CHA2DS2-VASc score were strong predictors of thromboembolic events in patients with NVAF