Severely reduced left atrial appendage function: A cause of embolic stroke in patients in sinus rhythm?

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Recently, attention has been focused on transesophageal echocardiographic detection of left atrial appendage function to assess of risk of thrombus formation because of potential benefit of anticoagulation therapy. However, most of these studies have been conducted in patients with atrial fibrillation or mitral valve disease. In this article we review cases of 2 patients without valvular disease who had embolic stroke in sinus rhythm. Transesophageal echocardiography revealed thrombi in the left atrial appendage in both patients. The left atrial appendage function in these patients was compared with that in patients with chronic atrial fibrillation and a control group in sinus rhythm. Left atrial appendage function in the patients with stroke and sinus rhythm was significantly lower than that of patients in the control group in sinus rhythm (P <.001) and was similar to the appendage function in patients with chronic atrial fibrillation. These observations provide further evidence that the finding of reduced left atrial appendage function can be a cause of stroke in patients with sinus rhythm even in the absence of mitral valve disease. Reduced left atrial appendage function may identify patients with unexplained stroke who should receive anticoagulation therapy even in the absence of detectable appendage thrombi.

Original languageEnglish (US)
Pages (from-to)902-904
Number of pages3
JournalJournal of the American Society of Echocardiography
Volume11
Issue number9
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Left Atrial Function
Atrial Appendage
Stroke
Atrial Fibrillation
Thrombosis
Mitral Valve
Control Groups
Transesophageal Echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{877a616df6de412e8c70c15bff0eff71,
title = "Severely reduced left atrial appendage function: A cause of embolic stroke in patients in sinus rhythm?",
abstract = "Recently, attention has been focused on transesophageal echocardiographic detection of left atrial appendage function to assess of risk of thrombus formation because of potential benefit of anticoagulation therapy. However, most of these studies have been conducted in patients with atrial fibrillation or mitral valve disease. In this article we review cases of 2 patients without valvular disease who had embolic stroke in sinus rhythm. Transesophageal echocardiography revealed thrombi in the left atrial appendage in both patients. The left atrial appendage function in these patients was compared with that in patients with chronic atrial fibrillation and a control group in sinus rhythm. Left atrial appendage function in the patients with stroke and sinus rhythm was significantly lower than that of patients in the control group in sinus rhythm (P <.001) and was similar to the appendage function in patients with chronic atrial fibrillation. These observations provide further evidence that the finding of reduced left atrial appendage function can be a cause of stroke in patients with sinus rhythm even in the absence of mitral valve disease. Reduced left atrial appendage function may identify patients with unexplained stroke who should receive anticoagulation therapy even in the absence of detectable appendage thrombi.",
author = "Masoor Kamalesh and Copeland, {T. B.} and Stephen Sawada",
year = "1998",
doi = "10.1016/S0894-7317(98)70011-2",
language = "English (US)",
volume = "11",
pages = "902--904",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "9",

}

TY - JOUR

T1 - Severely reduced left atrial appendage function

T2 - A cause of embolic stroke in patients in sinus rhythm?

AU - Kamalesh, Masoor

AU - Copeland, T. B.

AU - Sawada, Stephen

PY - 1998

Y1 - 1998

N2 - Recently, attention has been focused on transesophageal echocardiographic detection of left atrial appendage function to assess of risk of thrombus formation because of potential benefit of anticoagulation therapy. However, most of these studies have been conducted in patients with atrial fibrillation or mitral valve disease. In this article we review cases of 2 patients without valvular disease who had embolic stroke in sinus rhythm. Transesophageal echocardiography revealed thrombi in the left atrial appendage in both patients. The left atrial appendage function in these patients was compared with that in patients with chronic atrial fibrillation and a control group in sinus rhythm. Left atrial appendage function in the patients with stroke and sinus rhythm was significantly lower than that of patients in the control group in sinus rhythm (P <.001) and was similar to the appendage function in patients with chronic atrial fibrillation. These observations provide further evidence that the finding of reduced left atrial appendage function can be a cause of stroke in patients with sinus rhythm even in the absence of mitral valve disease. Reduced left atrial appendage function may identify patients with unexplained stroke who should receive anticoagulation therapy even in the absence of detectable appendage thrombi.

AB - Recently, attention has been focused on transesophageal echocardiographic detection of left atrial appendage function to assess of risk of thrombus formation because of potential benefit of anticoagulation therapy. However, most of these studies have been conducted in patients with atrial fibrillation or mitral valve disease. In this article we review cases of 2 patients without valvular disease who had embolic stroke in sinus rhythm. Transesophageal echocardiography revealed thrombi in the left atrial appendage in both patients. The left atrial appendage function in these patients was compared with that in patients with chronic atrial fibrillation and a control group in sinus rhythm. Left atrial appendage function in the patients with stroke and sinus rhythm was significantly lower than that of patients in the control group in sinus rhythm (P <.001) and was similar to the appendage function in patients with chronic atrial fibrillation. These observations provide further evidence that the finding of reduced left atrial appendage function can be a cause of stroke in patients with sinus rhythm even in the absence of mitral valve disease. Reduced left atrial appendage function may identify patients with unexplained stroke who should receive anticoagulation therapy even in the absence of detectable appendage thrombi.

UR - http://www.scopus.com/inward/record.url?scp=0031723492&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031723492&partnerID=8YFLogxK

U2 - 10.1016/S0894-7317(98)70011-2

DO - 10.1016/S0894-7317(98)70011-2

M3 - Article

C2 - 9758383

AN - SCOPUS:0031723492

VL - 11

SP - 902

EP - 904

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

IS - 9

ER -