Value of speckle tracking echocardiography for prediction of stroke risk in atrial fibrillation: Time to spare a stare outside the box?

Saha, Samir K.; Kiotsekoglou, Anatoli

doi:10.1111/echo.14005

Cited by 4 publications

(1 citation statement)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For these reasons, measurement of functional echocardiographic parameters might also provide additional insights into the major site of thromboembolism in AF patients [ 42 , 47 ]. Notably, severely impaired LA strain, reflecting advanced atrial cardiomyopathy [ 48 , 49 ] and decreased LAA flow velocities measured at TEE, is associated with a thromboembolic state [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Mechanical concordance between left atrium and left atrial appendage in nonvalvular atrial fibrillation: can it be exploited to avoid transesophageal echocardiography prior to electrical cardioversion during Covid-19 pandemic?

Sonaglioni

Lombardo

Nicolosi³

et al. 2021

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Transesophageal echocardiography (TEE) is the gold standard for assessing left atrial appendage (LAA) mechanic and thrombosis (LAAT); however, TEE is a high-risk procedure for viral transmission during coronavirus disease 2019 (COVID-19) pandemic. We investigated whether deformation indices of left atrium (LA) at transthoracic echocardiography (TTE) correlate with those of LAA assessed by TEE in nonvalvular atrial fibrillation (NVAF) patients undergoing electrical cardioversion (ECV). Consecutive patients with NVAF of ≥ 48 h or unknown duration, who underwent TEE and TTE at our Institution before ECV were retrospectively investigated. Standard echo-Doppler and LA and LAA myocardial strain and strain rate parameters were analyzed. A total of 115 NVAF patients (71.3 ± 8.1 yr/o, 59.1% men) were included: LAAT was diagnosed in 25 (21.7%) patients. Compared to patients without LAAT, those with LAAT had significantly higher CHA 2 DS 2 -VASc Risk score (4.5 ± 1.4 vs. 3.5 ± 1.1, p < 0.001), and lower ejection fraction (46.0 ± 14.8 vs. 57.6 ± 8.6%, p < 0.001). In LAAT patients, global strain of LA (8.7 ± 2.6 vs. 16.3 ± 4.5%, p < 0.001) and LAA (7.0 ± 1.7 vs. 11.7 ± 2.0%, p < 0.001) was significantly reduced compared to non-LAAT patients. A close relationship between left atrial strain reservoir (LASr) and LAA-global strain was demonstrated (r = 0.81). By univariable analysis, CHA 2 DS 2 -VASc Risk Score (OR 2.01, 95%CI 1.34–3.00), NT-proBNP (OR 1.36, 95%CI 1.19–1.54), ejection fraction (OR 0.92, 95%CI 0.88–0.96), E/e’ ratio (OR 2.07, 95%CI 1.51–2.85), and LASr (OR 0.39, 95%CI 0.25–0.62) were strongly associated with LAAT presence at TEE. By multivariable analysis, only LASr (OR 0.40, 95%CI 0.24–0.70) retained statistical significance. ROC curve analysis revealed that an LASr cut-off value ≤ 9.3% had 98.9% sensibility and 100% specificity to identify LAAT by TEE (AUC = 0.98). In patients with NVAF of ≥ 48 h or unknown duration, scheduled to undergo ECV, LA deformation assessment by TTE might substitute invasive measurement of LAA function by TEE, simplifying diagnostic approach and possibly contributing to reduce COVID-19 infection diffusion. Supplementary Information The online version contains supplementary material available at 10.1007/s10554-021-02414-w.

show abstract

Section: Discussionmentioning

confidence: 99%

Mechanical concordance between left atrium and left atrial appendage in nonvalvular atrial fibrillation: can it be exploited to avoid transesophageal echocardiography prior to electrical cardioversion during Covid-19 pandemic?

Sonaglioni

Lombardo

Nicolosi³

et al. 2021

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

show abstract

Incremental diagnostic role of left atrial strain analysis in thrombotic risk assessment of nonvalvular atrial fibrillation patients planned for electrical cardioversion

Sonaglioni

Lombardo

Nicolosi³

et al. 2021

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Cardiac Echocardiographic Analysis with Multi-Scale Effective Fusion Module: A Novel Stroke Prediction Approach

xie,

Tan,

Zheng

et al. 2024

Preprint

View full text Add to dashboard Cite

Purpose: To develop a stroke risk prediction model by integrating echocardiographic images (long-axis, short-axis, four-chamber views) and clinical indicators using a novel multi-scale effective fusion (MSEF) module. Methods: A total of 712 patients with 10,992 images and 27 clinical indicators were included. The MSEF module enhances multi-scale feature fusion by combining deep semantic and shallow high-resolution features. It consists of four components: Global Feature Fusion (GFF), Multi-Feature Reconstruction (MFR), Channel Attention, and Positional Attention, effectively improving small-target feature representation. The fused features and clinical indicators were used to train the stroke prediction model. Results: The proposed MSEF-based model achieved the highest performance, with an Accuracy of 76.8% and F1 Score of 64.7% on the test set. Ablation studies confirmed the importance of Channel Attention and Position Attention in enhancing feature representation. When integrating echocardiographic features with clinical indicators, the model achieved an Accuracy of 80.2% and F1 Score of 72.1% on the test set. Conclusion: The proposed MSEF-based approach effectively integrates imaging and clinical data, improving stroke risk prediction accuracy and offering a promising tool for clinical decision-making.

show abstract

Value of speckle tracking echocardiography for prediction of stroke risk in atrial fibrillation: Time to spare a stare outside the box?

Cited by 4 publications

References 20 publications

Mechanical concordance between left atrium and left atrial appendage in nonvalvular atrial fibrillation: can it be exploited to avoid transesophageal echocardiography prior to electrical cardioversion during Covid-19 pandemic?

Mechanical concordance between left atrium and left atrial appendage in nonvalvular atrial fibrillation: can it be exploited to avoid transesophageal echocardiography prior to electrical cardioversion during Covid-19 pandemic?

Incremental diagnostic role of left atrial strain analysis in thrombotic risk assessment of nonvalvular atrial fibrillation patients planned for electrical cardioversion

Cardiac Echocardiographic Analysis with Multi-Scale Effective Fusion Module: A Novel Stroke Prediction Approach

Contact Info

Product

Resources

About