Left Atrial Volume Index and Left Atrial Appendage Flow Velocities
| Status: | Not yet recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 4/21/2016 |
| Start Date: | July 2015 |
| End Date: | July 2017 |
| Contact: | Elsayed Abo-salem |
| Phone: | 513-558-1032 |
After obtaining a consent, bed side cardiac ultrasonography will be performed for cases
undergoing transesophageal echocardiography to evaluate the correlation between left atrium
volume and left atrial appendage flow velocity which can predict the thrombosis risk.
undergoing transesophageal echocardiography to evaluate the correlation between left atrium
volume and left atrial appendage flow velocity which can predict the thrombosis risk.
Informed consent will be obtained prior to any research related procedures Prior to
performing the transesophageal echocardiography, 4 and a 2-chamber transthoracic images will
be obtained to perform standard left atrial volumetric assessment as well as speckle
tracking interrogation. Both these procedures will be performed offline. The transesophageal
echocardiography will be performed using available equipment with a 5- to 7-megaHertz
multiplane transducer and according to standard of care. All images will be acquired per
American Society of Echocardiography guidelines and will be recorded for further analysis.
The left atrial appendage will be best visualized in the 60, 90 and 110 degree imaging
planes and left atrial appendage contraction velocity will be recorded by placing a pulsed
wave Doppler sample volume inside the proximal third of the left atrial appendage at each
angle. In addition, images will be recorded using a 3-beat cycle capture to later perform
offline velocity vector imaging analysis for left atrial appendage speckle tracking
analysis. The transthoracic echocardiography will be performed just before the
transesophageal echocardiography examination using a 2- to 4-megaHertz transducer and
according to standard practice guidelines. The following echocardiographic variables will be
prospectively measured and calculated: left ventricle ejection fraction using Simpson
method, left atrial volume will be measured using biplane method and left atrium volume
index is calculated based on body surface area. Tissue Doppler images of mitral valve
annulus will be measured and Pulsed wave Doppler of mitral inflow velocity.
Study does not include follow up. Study duration is up to 24 months
performing the transesophageal echocardiography, 4 and a 2-chamber transthoracic images will
be obtained to perform standard left atrial volumetric assessment as well as speckle
tracking interrogation. Both these procedures will be performed offline. The transesophageal
echocardiography will be performed using available equipment with a 5- to 7-megaHertz
multiplane transducer and according to standard of care. All images will be acquired per
American Society of Echocardiography guidelines and will be recorded for further analysis.
The left atrial appendage will be best visualized in the 60, 90 and 110 degree imaging
planes and left atrial appendage contraction velocity will be recorded by placing a pulsed
wave Doppler sample volume inside the proximal third of the left atrial appendage at each
angle. In addition, images will be recorded using a 3-beat cycle capture to later perform
offline velocity vector imaging analysis for left atrial appendage speckle tracking
analysis. The transthoracic echocardiography will be performed just before the
transesophageal echocardiography examination using a 2- to 4-megaHertz transducer and
according to standard practice guidelines. The following echocardiographic variables will be
prospectively measured and calculated: left ventricle ejection fraction using Simpson
method, left atrial volume will be measured using biplane method and left atrium volume
index is calculated based on body surface area. Tissue Doppler images of mitral valve
annulus will be measured and Pulsed wave Doppler of mitral inflow velocity.
Study does not include follow up. Study duration is up to 24 months
Inclusion Criteria:
- Study will include all patients 18-80 years of age and referred for transesophageal
evaluation of left atrium or left atrium appendage for appropriate clinical
indications, at the University of Cincinnati University Medical Center and VA Medical
Center.
Exclusion Criteria:
- Patients with either moderate to sever mitral valve disease or previous prosthetic
mitral replacement.
- Patients with acute heart failure
- History of previous left atrium appendage surgical intervention.
- Pregnant women
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