Left Atrial Appendage Thrombi detection by echocardiography in Non-Valvular Atrial Fibrillation: Prospective study: A Cross-Sectional Study | ||||
| Zagazig University Medical Journal | ||||
| Articles in Press, Accepted Manuscript, Available Online from 02 September 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2025.407462.4082 | ||||
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| Authors | ||||
Hala Gouda1; Mohammad M Al-Daydammony2; Ahmed Albaramawy  3; Mohammad Abdelhady1
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| 1Cardiology department, Faculty of Medicine, Zagazig University, Zagazig, Egypt | ||||
| 2Cardiology Department , Faculty of medicine , Zagazig University , Zagazig , Egypt | ||||
| 3Cardiology department, Faculty of Medicine, Zagazig University | ||||
| Abstract | ||||
| Background: Non-valvular atrial fibrillation (NVAF) increases stroke risk, primarily from left atrial appendage (LAA) thrombi. Although TEE is superior for detection, transthoracic echocardiography (TTE) measures like atrial size may help early risk assessment. The predictive role of transthoracic echocardiography (TTE) parameters and related biomarkers remains uncertain. This study aimed to assess whether TTE-derived measures together with laboratory markers, can predict LAA thrombus and spontaneous echo contrast in NVAF patients efficiently. Methods: This cross-sectional study at cardio department of Zagazig University Hospital involved 26 NVAF patients underwent clinical evaluation, lab tests, TTE for LA measurements, TEE and Doppler techniques for comprehensive thromboembolic risk evaluation. Data were analyzed using SPSS v20.0. Means, percentages, and standard deviations were reported. Appropriate parametric and non-parametric tests, along with logistic regression, were used. Significance was set at p < 0.05. Results: The mean age was 63.2±17.1 years, with 50% males; hypertension was most common (69.2%). LAA thrombus was linked to older age (P=0.0208) and higher AST (P=0.0329). Thrombus patients had higher LAESV, LAEDV, lower EF, and reduced LAA velocity (P<0.05). Positive associations existed with D-dimer (P<0.0001, CI:0.242–0.469), ALT (P=0.004, CI:0.013–0.061), LAESV (P<0.0001, CI:0.019–0.037), LAEDV (P=0.029, CI:0.001–0.018); negative with albumin (P=0.022, CI:-1.127–-0.097), EF (P=0.001, CI:-0.068–-0.02), and LAA velocity (P=0.002, CI:-0.041–-0.011). Conclusion: Transthoracic echocardiography offers non-invasive indicators of LAA thrombus risk in NVAF, including atrial volumes, ejection fraction, and LAA velocity, supported by biomarkers like D-dimer and albumin. Though TEE is definitive, these parameters aid early risk stratification and anticoagulation decisions. | ||||
| Keywords | ||||
| Non-valvular atrial fibrillation; echocardiography; left atrium; left atrial appendage thrombi | ||||
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