Comparison of tissue Doppler dynamics to Doppler flow in evaluating left atrial appendage function by transesophageal echocardiography

      Tissue Doppler imaging (TDI) patterns from the left atrial appendage (LAA) were evaluated by transesophageal echocardiography. Reproducible, characteristic triphasic or biphasic tissue velocities similar to Doppler flow of the LAA were obtained. Patient peak TDI velocities correlated well with flow and were measurable in atrial fibrillation. Patients with an embolic cerebrovascular accident and in sinus rhythm had higher tissue TDI velocities from the LAA compared with patients without an event, and the groups had similar flow velocities. Hence, Doppler tissue contraction dynamics determined by TDI may complement flow velocities in evaluating LAA function for risk assessment of thromboembolism.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Aschenberg W.
        • Shluter M.
        • Kremer P.
        • Schroder E.
        • Siglow V.
        • Bleifeld W.
        Transesophageal two-dimensional echocardiography for the detection of left atrial appendage thrombus.
        J Am Coll Cardiol. 1986; 7: 163-166
        • Pollick C.
        • Taylor D.
        Assessment of left atrial appendage function by transesophageal echocardiography.
        Circulation. 1991; 84: 223-231
        • Manning W.J.
        • Weintraub R.M.
        • Waksmonski C.A.
        • Haering J.M.
        • Rooney P.S.
        • Malow A.D.
        • Johnson R.G.
        • Douglas P.S.
        Accuracy of transesophageal echocardiography for identifying left atrial thrombi.
        Ann Intern Med. 1995; 123: 373-379
        • Daniel W.G.
        • Nellessen U.
        • Schroder E.
        • Nonnast-Daniel B.
        • Bednarski P.
        • Nikutta P.
        • Lichtlen P.R.
        Left atrial spontaneous echo contrast in mitral valve disease: an indicator for an increased thromboembolic risk.
        J Am Coll Cardiol. 1988; 11: 1204-1211
        • Fatkin D.
        • Feneley M.
        Stratification of thromboembolic risk of atrial fibrillation by transthoracic echocardiography and transesophageal echocardiography: the relative role of left atrial appendage function, mitral valve disease, and spontaneous echocardiographic contrast.
        Prog Cardiovasc Dis. 1996; 39: 57-68
        • Kamalesh M.
        • Copeland T.B.
        • Sawada S.
        Severely reduced left atrial appendage function: a cause of embolic stroke in patients in sinus rhythm?.
        J Am Soc Echocardiogr. 1998; 11: 902-904
        • Trambaiolo P.
        • Salustri A.
        • Tanga M.
        • Tonti G.
        • Fedele F.
        • Palamara A.
        Assessment of left atrial appendage wall velocities by transesophageal tissue Doppler echocardiography: a clinical study in patients with sinus rhythm.
        J Am Soc Echocardiogr. 2002; 15: 425-432
        • Galiuto L.
        • Ignone G.
        • DeMaria A.N.
        Contraction and relaxation velocities of the normal left ventricle using pulsed-wave tissue Doppler echocardiography.
        Am J Cardiol. 1998; 81: 609-614
        • Waggoner A.D.
        • Bierig S.M.
        Tissue Doppler imaging: a useful echocardiographic method for the cardiac sonographer to assess systolic and diastolic ventricular function.
        J Am Soc Echocardiogr. 2001; 14: 1143-1152
        • Fatkin D.
        • Feneley M.P.
        Patterns of Doppler-measured blood flow velocity in the normal and fibrillating human left atrial appendage.
        Am Heart J. 1996; 132: 995-1003
        • Agmon Y.
        • Khandheria B.K.
        • Meissner I.
        • Petterson T.M.
        • O'Fallon W.M.
        • Wiebers D.O.
        • Seward J.B.
        Are left atrial appendage flow velocities adequate surrogates of global left atrial function?.
        A population-based transthoracic and transesophageal echocardiographic study. J Am Soc Echocardiogr. 2002; 15: 433-440
        • Agmon Y.
        • Khandheria B.K.
        • Gentile F.
        • Seward J.B.
        Clinical and echocardiographic characteristics of patients with left atrial thrombus and sinus rhythm: experience in 20,643 consecutive transesophageal echocardiographic examinations.
        Circulation. 2002; 105: 27-31
        • Bollmann A.
        • Binias K.H.
        • Grothues F.
        • Schwerdtfeger A.
        • Klein H.U.
        Left atrial appendage function and pulmonary venous flow in patients with nonrheumatic atrial fibrillation and their relation to spontaneous echo contrast.
        Echocardiography. 2002; 19: 37-43