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KMID : 0390619930010010109
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Journal of Cardiovascular Ultrasound
1993 Volume.1 No. 1 p.109 ~ p.118
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Evaluation of left Atrial Appendage Function by Transesophageal Echocardiography :
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신경철
강승호/신동구/김영조/심봉섭/이현우
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Abstract
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Background :
@EN Transesophageal echocardiography provides highly accurate image of left atrium and particularly of left atrial appendage (LAA). This technique is currently used for assessment of left atrial spontanous echocardiographic contrast and LAA
thrombi
and
their relationship, together with clinical outcome.
@ES Method :
@EN Prospectively it was studied that the two dimensional echocardiographic and Doppler pattern of LAA function in 71 patients by transesophageal echocardiography. In the 36patients in sinus rhythm, LAA area was measured during LAA diastole at
the
onset of electrocardiographic p wave (LAA max) and after v systole at the ECG R wave (LAA min)and LAA ejection fraction fraction was calculated as (LAA max-LAA min/LAA max In the patients 35 patients with atrial fibrillation or flutter LAA max
was
measured independant of ECG Peak Doppler velocity was recorded from LAA outlet.
@ES Result :
@EN Three different LAA flow patterns were identified. Type I flow, characterized by a biphasic pattern (wave of filling and emptying), was found in patients, all sinus rhythm ; it was not associated with LA spontaneous contrast or thrombus Peak
velocity of the filling and emptying weve were, respectively : Type II sawtooth active (nineteen patients) (LAA peak svstolic velocity and LAA peak systolic velocity : 23.36±14.15 and 21.43±10.7cm/sec)was detected in atrial arrhythmia and
dilated
LAA(LAA max and LAA min : 7.65±2.56 and 5.77±2.43㎠) but without thrombus or significant LAA spontaneous echocardiographic contrast. Type III flow pattern was characterized by the absence of identifiable flow waves and was associated with the
presence of LAA spontaneous contrast ; six of fourteen had evidence of thrombus. In patients with LA contrast and/or thrombus had LAA max and LAA min greater than that in patients without LAA contrast and/or thrombus. In patients with LA
contrast
and/or thrombus had LAAEF and LAA peak velocity lesser than that in patients without LAA contrast and/or thrombus.
@ES Conclusion
@EN It was concluded that the LAA thrombus formation is associated with poor LAA contraction LAA dilation and absent or low blood flow velocity.
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KEYWORD
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