Impact of left atrial appendage occlusion on left atrial function—The LAFIT Watchman study

Ghulam Murtaza, Venkat Vuddanda, Krishna Akella, Domenico G. Della Rocca, Sharan Sharma, Ling Li, Shelby Kutty, Mohit Turagam, Saibal Kar, David Holmes, Dhanunjaya Lakkireddy

Research output: Contribution to journalArticle

Abstract

Background: Left atrial (LA) strain and strain rate (SR) analysis by two-dimensional speckle tracking echocardiography is a novel way of LA function assessment. From prior study, we know that LA appendage closure with LARIAT appears to improve LA function. Objective: The purpose of this study was to assess the impact of LAA closure via Watchman device on LA function via strain and volumetric analyses using two-dimensional speckle tracking echocardiography (2D-STE). Methods: Twenty-five patients who underwent Watchman device implantation (WDI) were included. LA function parameters (volumetric, strain indices) were calculated from apical four chamber views with the reference point set at QRS using 2D-STE before and after WDI. LA expansion index, strain and strain rate during ventricular systole represent LA reservoir function. Passive emptying fraction, strain and strain rate during early ventricular diastole represent LA conduit function. Results: Mean age was 76 ± 6.9 years with 60% males. There was significant improvement in conduit function (LA passive emptying fraction; post 28.6 (21.9–35.9) vs pre 21.0 (13.8–34.7), p = 0.032), reservoir function (LA expansion index; post 75.3 (52.3–98.0) vs pre 58.1 (37.8–85.2), p = 0.026), and booster function (LA active emptying fraction; post 13.3 (9.7–29.9) vs pre 12.6 (8.8–25.5), p = 0.04) by volumetric indices. No significant improvement was noted with strain indices in conduit function (SRe; post − 0.56 (0.43–0.93) vs pre − 0.58 (0.46–0.87); p = 0.518) and reservoir function (SRs; post + 0.58 (0.28–0.40) vs pre + 0.52 (0.35–0.86); p = 0.851). Conclusions: WDI resulted in discrepancy of volumetric and strain indices in LA function assessment.

Original languageEnglish (US)
JournalJournal of Interventional Cardiac Electrophysiology
DOIs
StateAccepted/In press - Jan 1 2019

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Left Atrial Function
Atrial Appendage
Equipment and Supplies
Echocardiography
Diastole
Systole

Keywords

  • Left atrial appendage
  • Speckle tracking echocardiography
  • Strain analysis
  • Watchman device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Impact of left atrial appendage occlusion on left atrial function—The LAFIT Watchman study. / Murtaza, Ghulam; Vuddanda, Venkat; Akella, Krishna; Della Rocca, Domenico G.; Sharma, Sharan; Li, Ling; Kutty, Shelby; Turagam, Mohit; Kar, Saibal; Holmes, David; Lakkireddy, Dhanunjaya.

In: Journal of Interventional Cardiac Electrophysiology, 01.01.2019.

Research output: Contribution to journalArticle

Murtaza, Ghulam ; Vuddanda, Venkat ; Akella, Krishna ; Della Rocca, Domenico G. ; Sharma, Sharan ; Li, Ling ; Kutty, Shelby ; Turagam, Mohit ; Kar, Saibal ; Holmes, David ; Lakkireddy, Dhanunjaya. / Impact of left atrial appendage occlusion on left atrial function—The LAFIT Watchman study. In: Journal of Interventional Cardiac Electrophysiology. 2019.
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abstract = "Background: Left atrial (LA) strain and strain rate (SR) analysis by two-dimensional speckle tracking echocardiography is a novel way of LA function assessment. From prior study, we know that LA appendage closure with LARIAT appears to improve LA function. Objective: The purpose of this study was to assess the impact of LAA closure via Watchman device on LA function via strain and volumetric analyses using two-dimensional speckle tracking echocardiography (2D-STE). Methods: Twenty-five patients who underwent Watchman device implantation (WDI) were included. LA function parameters (volumetric, strain indices) were calculated from apical four chamber views with the reference point set at QRS using 2D-STE before and after WDI. LA expansion index, strain and strain rate during ventricular systole represent LA reservoir function. Passive emptying fraction, strain and strain rate during early ventricular diastole represent LA conduit function. Results: Mean age was 76 ± 6.9 years with 60{\%} males. There was significant improvement in conduit function (LA passive emptying fraction; post 28.6 (21.9–35.9) vs pre 21.0 (13.8–34.7), p = 0.032), reservoir function (LA expansion index; post 75.3 (52.3–98.0) vs pre 58.1 (37.8–85.2), p = 0.026), and booster function (LA active emptying fraction; post 13.3 (9.7–29.9) vs pre 12.6 (8.8–25.5), p = 0.04) by volumetric indices. No significant improvement was noted with strain indices in conduit function (SRe; post − 0.56 (0.43–0.93) vs pre − 0.58 (0.46–0.87); p = 0.518) and reservoir function (SRs; post + 0.58 (0.28–0.40) vs pre + 0.52 (0.35–0.86); p = 0.851). Conclusions: WDI resulted in discrepancy of volumetric and strain indices in LA function assessment.",
keywords = "Left atrial appendage, Speckle tracking echocardiography, Strain analysis, Watchman device",
author = "Ghulam Murtaza and Venkat Vuddanda and Krishna Akella and {Della Rocca}, {Domenico G.} and Sharan Sharma and Ling Li and Shelby Kutty and Mohit Turagam and Saibal Kar and David Holmes and Dhanunjaya Lakkireddy",
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T1 - Impact of left atrial appendage occlusion on left atrial function—The LAFIT Watchman study

AU - Murtaza, Ghulam

AU - Vuddanda, Venkat

AU - Akella, Krishna

AU - Della Rocca, Domenico G.

AU - Sharma, Sharan

AU - Li, Ling

AU - Kutty, Shelby

AU - Turagam, Mohit

AU - Kar, Saibal

AU - Holmes, David

AU - Lakkireddy, Dhanunjaya

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Left atrial (LA) strain and strain rate (SR) analysis by two-dimensional speckle tracking echocardiography is a novel way of LA function assessment. From prior study, we know that LA appendage closure with LARIAT appears to improve LA function. Objective: The purpose of this study was to assess the impact of LAA closure via Watchman device on LA function via strain and volumetric analyses using two-dimensional speckle tracking echocardiography (2D-STE). Methods: Twenty-five patients who underwent Watchman device implantation (WDI) were included. LA function parameters (volumetric, strain indices) were calculated from apical four chamber views with the reference point set at QRS using 2D-STE before and after WDI. LA expansion index, strain and strain rate during ventricular systole represent LA reservoir function. Passive emptying fraction, strain and strain rate during early ventricular diastole represent LA conduit function. Results: Mean age was 76 ± 6.9 years with 60% males. There was significant improvement in conduit function (LA passive emptying fraction; post 28.6 (21.9–35.9) vs pre 21.0 (13.8–34.7), p = 0.032), reservoir function (LA expansion index; post 75.3 (52.3–98.0) vs pre 58.1 (37.8–85.2), p = 0.026), and booster function (LA active emptying fraction; post 13.3 (9.7–29.9) vs pre 12.6 (8.8–25.5), p = 0.04) by volumetric indices. No significant improvement was noted with strain indices in conduit function (SRe; post − 0.56 (0.43–0.93) vs pre − 0.58 (0.46–0.87); p = 0.518) and reservoir function (SRs; post + 0.58 (0.28–0.40) vs pre + 0.52 (0.35–0.86); p = 0.851). Conclusions: WDI resulted in discrepancy of volumetric and strain indices in LA function assessment.

AB - Background: Left atrial (LA) strain and strain rate (SR) analysis by two-dimensional speckle tracking echocardiography is a novel way of LA function assessment. From prior study, we know that LA appendage closure with LARIAT appears to improve LA function. Objective: The purpose of this study was to assess the impact of LAA closure via Watchman device on LA function via strain and volumetric analyses using two-dimensional speckle tracking echocardiography (2D-STE). Methods: Twenty-five patients who underwent Watchman device implantation (WDI) were included. LA function parameters (volumetric, strain indices) were calculated from apical four chamber views with the reference point set at QRS using 2D-STE before and after WDI. LA expansion index, strain and strain rate during ventricular systole represent LA reservoir function. Passive emptying fraction, strain and strain rate during early ventricular diastole represent LA conduit function. Results: Mean age was 76 ± 6.9 years with 60% males. There was significant improvement in conduit function (LA passive emptying fraction; post 28.6 (21.9–35.9) vs pre 21.0 (13.8–34.7), p = 0.032), reservoir function (LA expansion index; post 75.3 (52.3–98.0) vs pre 58.1 (37.8–85.2), p = 0.026), and booster function (LA active emptying fraction; post 13.3 (9.7–29.9) vs pre 12.6 (8.8–25.5), p = 0.04) by volumetric indices. No significant improvement was noted with strain indices in conduit function (SRe; post − 0.56 (0.43–0.93) vs pre − 0.58 (0.46–0.87); p = 0.518) and reservoir function (SRs; post + 0.58 (0.28–0.40) vs pre + 0.52 (0.35–0.86); p = 0.851). Conclusions: WDI resulted in discrepancy of volumetric and strain indices in LA function assessment.

KW - Left atrial appendage

KW - Speckle tracking echocardiography

KW - Strain analysis

KW - Watchman device

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