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Assessment of left atrial appendage function by echocardiography

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Abstract

The left atrial appendage (LAA) is considered not only to be the most frequent site of thrombus formation, but also to play a pivotal role in maintaining normal cardiac function. Transesophageal echocardiography (TEE) is widely used to assess LAA function. The LAA flow velocity has been used as a surrogate for LAA function, and it varies with multiple interrelated factors including age, hemodynamics, type of arrhythmia, and antiarrhythmic interventions. Relatively great importance of LAA function is involved with intraatrial thrombus formation and subsequent thromboembolism, and thus, understanding of characteristics and behaviors of the LAA under various clinical conditions may help determine strategies against atrial thrombosis. Also, techniques other than TEE-derived Doppler to assess LAA function, such as tissue Doppler imaging, have been proposed. In this review, we introduce clinical and echocardiographic correlates of LAA function, the LAA flow velocity in particular, its significance, and how to interpret functional patterns of the LAA each relevant to specific clinical settings.

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References

  1. Beigel R, Wunderlich NC, Ho SY, Arsanjani R, Siegel RJ (2014) The left atrial appendage: anatomy, function, and noninvasive evaluation. JACC Cardiovasc Imaging 7(12):1251–1265. https://doi.org/10.1016/j.jcmg.2014.08.009

  2. Patti G, Pengo V, Marcucci R, Cirillo P, Renda G, Santilli F, Calabrò P, De Caterina AR, Cavallari I, Ricottini E, Parato VM, Zoppellaro G, Di Gioia G, Sedati P, Cicchitti V, Davì G, Golia E, Pariggiano I, Simeone P, Abbate R, Prisco D, Zimarino M, Sofi F, Andreotti F, De Caterina R; Working Group of Thrombosis of the Italian Society of Cardiology (2017) The left atrial appendage: from embryology to prevention of thromboembolism. Eur Heart J 38(12):877–887. https://doi.org/10.1093/eurheartj/ehw159

  3. Leung DY, Black IW, Cranney GB, Hopkins AP, Walsh WF (1994) Prognostic implications of left atrial spontaneous echo contrast in nonvalvular atrial fibrillation. J Am Coll Cardiol 24:755–762. https://doi.org/10.1016/0735-1097(94)90025-6

  4. Black IW, Hopkins AP, Lee LC, Walsh WF (1991) Left atrial spontaneous echo contrast: a clinical and echocardiographic analysis. J Am Coll Cardiol 18:398–404. https://doi.org/10.1016/0735-1097(91)90592-w

  5. Fatkin D, Kelly RP, Feneley MP (1994) Relations between left atrial appendage blood flow velocity, spontaneous echocardiographic contrast and thromboembolic risk in vivo. J Am Coll Cardiol 23:961–969. https://doi.org/10.1016/0735-1097(94)90644-0

  6. Hoit BD, Shao Y, Tsai LM, Patel R, Gabel M, Walsh RA (1993) Altered left atrial compliance after atrial appendectomy. Influence on left atrial and ventricular filling. Circ Res 72(1):167–175. https://doi.org/10.1161/01.res.72.1.167

  7. Davis CA, Rembert JC, Greenfield JC Jr (1990) Compliance of left atrium with and without left atrium appendage. Am J Physiol 259:H1006–1008. https://doi.org/10.1152/ajpheart.1990.259.4.H1006

  8. Tabata T, Oki T, Yamada H, Iuchi A, Ito S, Hori T, Kitagawa T, Kato I, Kitahata H, Oshita S (1998) Role of eft atrial appendage in left atrial reservoir function as evaluated by left atrial appendage clamping during cardiac surgery. Am J Cardiol 81(3):327–332. https://doi.org/10.1016/s0002-9149(97)00903-x

  9. Hoit BD, Shao Y, Gabel M (1994) Influence of acutely altered loading conditions on left atrial appendage flow velocities. J Am Coll Cardiol 24(4):1117–1123. https://doi.org/10.1016/0735-1097(94)90878-8

  10. Ito T, Suwa M, Kobashi A, Yagi H, Hirota Y, Kawamura K (1998) Influence of altered loading conditions on left atrial appendage function in vivo. Am J Cardiol 81(8):1056–1059. https://doi.org/10.1016/s0002-9149(98)00011-3

  11. Mikael Kortz RA, Delemarre BJ, van Dantzig JM, Bot H, Kamp O, Visser CA (1993) Left atrial appendage blood flow determined by transesophageal echocardiography in healthy subjects. Am J Cardiol 71(11):976–981. https://doi.org/10.1016/0002-9149(93)90917-2

  12. Tabata T, Oki T, Fukuda N, Iuchi A, Manabe K, Kageji Y, Sasaki M, Yamada H, Ito S (1996) Influence of aging on left atrial appendage flow velocity patterns in normal subjects. J Am Soc Echocardiogr 9(3):274–280. https://doi.org/10.1016/s0894-7317(96)90140-6

  13. Goldberg YH, Gordon SC, Spevack DM, Gordon GM (2010) Disparities in emptying velocity within the left atrial appendage. Eur J Echocardiogr 11(3):290–295. https://doi.org/10.1093/ejechocard/jep216

  14. Agmon Y, Khandheria BK, Gentile F, Seward JB (1999) Echocardiographic assessment of the left atrial appendage. J Am Coll Cardiol 34:1867–1877. https://doi.org/10.1016/s0735-1097(99)00472-6

  15. Noda T, Arakawa M, Miwa H, Ito Y, Kagawa K, Nishigaki K, Hirakawa S, Fujiwara H (1996) Effects of heart rate on flow velocity of the left atrial appendage in patients with nonvalvular atrial fibrillation Clin Cardiol 19(4):295–300. https://doi.org/10.1002/clc.4960190404

  16. Santiago D, Warshofsky M, Li Mandri G, Di Tullio M, Coromilas J, Reiffel J, Homma S (1994) Left atrial appendage function and thrombus formation in atrial fibrillation-flutter: a transesophageal echocardiographic study. J Am Coll Cardiol 24:159–164. https://doi.org/10.1016/0735-1097(94)90557-6

  17. Kato H, Yoshida M, Takata K, Kanehara H, Maekawa N, Ohnishi T, Murakita H, Kuriyama T, Yamamoto M (1999) Hemodynamic abnormalities in the left atrial appendage in patients with paroxysmal atrial fibrillation, with special reference to albumin-contrast echocardiographic aspects. Cardiology 92:135–143. https://doi.org/10.1159/000006961

  18. Goldman ME, Pearce LA, Hart RG, Zabalgoitia M, Asinger RW, Safford R, Halperin JL (1999) Pathophysiologic correlates of thromboembolism in nonvalvular atrial fibrillation: I. Reduced flow velocity in the left atrial appendage (The Stroke Prevention in Atrial Fibrillation [SPAF-III] study). J Am Soc Echocardiogr 12:1080–1087. https://doi.org/10.1016/s0894-7317(99)70105-7

  19. Li YH, Lai LP, Shyu KG, Hwang JJ, Kuan P, Lien WP (1994) Clinical implications of left atrial appendage flow patterns in nonrheumatic atrial fibrillation. Chest 105:748–752. https://doi.org/10.1378/chest.105.3.748

  20. Mitusch R, Garbe M, Schmücker G, Schwabe K, Stierle U, Sheikhzadeh A (1995) Relation of left atrial appendage function to the duration and reversibility of nonvalvular atrial fibrillation. Am J Cardiol 75(14):944–947. https://doi.org/10.1016/s0002-9149(99)80695-x

  21. Omran H, Jung W, Rabahieh R, MacCarter D, Illien S, Rang B, Hagendorff A, Schimpf R, Lüderitz B (1997) Left atrial appendage function inpatients with atrial flutter. Heart 78(3):250–254. https://doi.org/10.1136/hrt.78.3.250

  22. Sakurai K, Hirai T, Nakagawa K, Kameyama T, Nozawa T, Asanoi H, Inoue H (2003) Left atrial appendage function and abnormal hypercoagulability in patients with atrial flutter. Chest 124(5):1670–1674. https://doi.org/10.1378/chest.124.5.1670

  23. Bansal M, Kasliwal RR (2012) Echocardiography for left atrial appendage structure and function. Indian Heart J 64:469–475. https://doi.org/10.1016/j.ihj.2012.07.020

  24. Manning WJ, Silverman DI (1996) Atrial anatomy and function postcardioversion: insights from transthoracic and transesophageal echocardiography. Prog Cardiovasc Dis 39:33–46. https://doi.org/10.1016/s0033-0620(96)80039-9

  25. Fatkin D, Kuchar DL, Thorburn CW, Feneley MP (1994) Transesophageal echocardiography before and during direct current cardioversion of atrial fibrillation: evidence for “atrial stunning” as a mechanism of thromboembolic complications. J Am Coll Cardiol 23:307–316. https://doi.org/10.1016/0735-1097(94)90412-x

  26. Ito T, Suwa M, Otake Y, Kobashi A, Hirota Y, Ando H, Kawamura K (1998) Assessment of left atrial appendage function after cardioversion of atrial fibrillation: relation to left atrial mechanical function. Am Heart J 135:1020–1026. https://doi.org/10.1016/s0002-8703(98)70067-5

  27. Grimm RA, Leung DY, Black IW, Stewart WJ, Thomas JD, Klein AL (1995) Left atrial appendage “stunning” after spontaneous conversion of atrial fibrillation demonstrated by transesophageal Doppler echocardiography. Am Heart J 130:174–176. https://doi.org/10.1016/0002-8703(95)90253-8

  28. Falcone RA, Morady F, Armstrong WF (1996) Transesophageal echocardiographic evaluation of left atrial appendage function and spontaneous contrast formation after chemical or electrical cardioversion of atrial fibrillation. Am J Cardiol 78:435–439. https://doi.org/10.1016/s0002-9149(96)00333-5

  29. Harjai K, Mobarek S, Abi-Samra F, Gilliland Y, Davison N, Drake K, Revall S, Cheirif J (1998) Mechanical dysfunction of the left atrium and the left atrial appendage following cardioversion of atrial fibrillation and its relation to total electrical energy used for cardioversion. Am J Cardiol 81:1125–1129.https://doi.org/10.1016/s0002-9149(98)00141-6

  30. Omran H, Jung W, Rabahieh R, Schimpf R, Wolpert C, Hagendorff A, Fehske W, Lüderitz B (1997) Left atrial chamber and appendage function after internal atrial defibrillation: a prospective and serial transesophageal echocardiographic study. J Am Coll Cardiol 29:131–138. https://doi.org/10.1016/s0735-1097(96)00439-1

  31. Yamada H, Donal E, Kim YJ, Agler DA, Zhang Y, Greenberg NL, Mazgalev TN, Thomas JD, Grimm RA (2004) The pseudorestrictive pattern of transmitral Doppler flow pattern after conversion of atrial fibrillation to sinus rhythm: is atrial or ventricular dysfunction to blame? J Am Soc Echocardiogr 17(8):813–818. https://doi.org/10.1016/j.echo.2004.04.021

  32. Kusa S, Komatsu Y, Taniguchi H, Uchiyama T, Takagi T, Nakamura H, Miyazaki S, Hachiya H, Iesaka Y (2015) Left atrial appendage flow velocity after successful ablation of persistent atrial fibrillation: clinical perspective from transesophageal echocardiographic assessment during sinus rhythm. Am Heart J 169(2):211–221. https://doi.org/10.1016/j.ahj.2014.11.009

  33. Machino-Ohtsuka T, Seo Y, Ishizu T, Yanaka S, Nakajima H, Atsumi A, Yamamoto M, Kawamura R, Koshino Y, Machino T, Kuroki K, Yamasaki H, Igarashi M, Sekiguchi Y, Tada H, Aonuma K (2013) Significant improvement of left atrial and left atrial appendage function after catheter ablation for persistent atrial fibrillation. Circ J 77(7):1695–1704. https://doi.org/10.1253/circj.cj-12-1518

  34. Al-Hijji MA, Deshmukh AJ, Yao X, Mwangi R, Sangaralingham LR, Friedman PA, Asirvatham SJ, Packer DL, Shah ND, Noseworthy PA (2016) Trends and predictors of repeat catheter ablation for atrial fibrillation. Am Heart J 171(1):48–55. https://doi.org/10.1016/j.ahj.2015.10.015

  35. Pérez Y, Duval AM, Carville C, Wéber H, Cachin JC, Castaigne A, Dubois-Randé JL, Guéret P (1997) Is left atrial appendage flow a predictor for outcome of cardioversion of nonvalvular atrial fibrillation? A transthroacic and transesophageal echocardiographic study. Am Heart J 134(4):745–51. https://doi.org/10.1016/s0002-8703(97)70059-0

  36. Wang YC, Lin LC, Lin MS, Lai LP, Hwang JJ, Tseng YZ, Tseng CD, Lin JL (2005) Identification of good responders to rhythm control of paroxysmal and persistent atrial fibrillation by transthoracic and transesophageal echocardiography. Cardiology 104(4):202–209. https://doi.org/10.1159/000088174

  37. Ma XX, Wang A, Lin K (2021) Incremental predictive value of left atrial strain and left atrial appendage function in rhythm outcome of non-valvular atrial fibrillation patients after catheter ablation. Open Heart 8(1):e001635. https://doi.org/10.1136/openhrt-2021-001635

  38. Kanda T, Masuda M, Sunaga A, Fujita M, Iida O, Okamoto S, Ishihara T, Watanabe T, Takahara M, Sakata Y, Uematsu M (2015) Low left atrial appendage flow velocity predicts recurrence of atrial fibrillation after catheter ablation of persistent atrial fibrillation. J Cardiol 66(5):377–381. https://doi.org/10.1016/j.jjcc.2015.04.009

  39. Combes S, Jacob S, Combes N, Karam N, Chaumeil A, Guy-Moyat B, Treguer F, Deplagne A, Boveda S, Marijon E, Albenque JP (2013) Predicting favourable outcomes in the setting of radiofrequency catheter ablation of long-standing persistent atrial fibrillation: a pilot study assessing the value of left atrial appendage peak flow velocity. Arch Cardiovasc Dis 106(1):36–43. https://doi.org/10.1016/j.acvd.2012.09.002

  40. Kanadaşı M, Caylı M, Sahin DY, Sen Ö, Koç M, Usal A, Batur MK, Demirtaş M (2011) The effect of different atrioventricular delays on left atrium and left atrial appendage function in patients with DDD pacemaker. Echocardiography 28(6):626–632. https://doi.org/10.1111/j.1540-8175.2011.01404.x

  41. Asanuma T, Tanabe K, Yoshitomi H, Shimizu H, Murakami Y, Sano K, Shimada T, Morioka S (1995) Left atrial appendage function in patients with single-chamber ventricular pacing. Am J Cardiol 76(11):840–842. https://doi.org/10.1016/s0002-9149(99)80241-0

  42. Simantirakis EN, Parthenakis FI, Chrysostomakis SI, Zuridakis EG, Igoumenidis NE, Vardas PE (1997) Left atrial appendage function during DDD and VVI pacing. Heart 77(5):428–431. https://doi.org/10.1136/hrt.77.5.428

  43. Ertaş F, Güleç S, Dinçer I, Erol C, Tutar E, Güldal M, Karaoğuz R, Oral D (2000) Left atrial appendage function in patients with different pacing modes. Int J Cardiol 73(2):135–141. https://doi.org/10.1016/s0167-5273(99)00221-1

  44. Yoshitomi H, Tanabe K, Asanuma T, Shimizu H, Kobayashi K, Ono M, Murakami Y, Sano K, Ishibashi Y, Shimada T (1998) Influence of cardiac pacing mode on left atrial appendage flow velocity: implication to systemic embolism during VVI pacing. Echocardiography 15(5):473–478. https://doi.org/10.1111/j.1540-8175.1998.tb00634.x

  45. Vural A, Agacdiken A, Ural D, Sahin T, Kozdag G, Kahraman G, Ural E, Akbas H, Suzer K, Komsuoglu B (2005) Effect of cardiac resynchronization therapy on left atrial appendage function and pulmonary venous flow pattern. Int J Cardiol 102(1):103–109. https://doi.org/10.1016/j.ijcard.2004.05.011

  46. Santangeli P, Marchlinski FE (2017) Techniques for the provocation, localization, and ablation of non-pulmonary vein triggers for atrial fibrillation. Heart Rhythm 14(7):1087–1096. https://doi.org/10.1016/j.hrthm.2017.02.030

  47. Di Biase L, Burkhardt JD, Mohanty P, Sanchez J, Mohanty S, Horton R, Gallinghouse GJ, Bailey SM, Zagrodzky JD, Santangeli P, Hao S, Hongo R, Beheiry S, Themistoclakis S, Bonso A, Rossillo A, Corrado A, Raviele A, Al-Ahmad A, Wang P, Cummings JE, Schweikert RA, Pelargonio G, Dello Russo A, Casella M, Santarelli P, Lewis WR, Natale A (2010) Left atrial appendage: an underrecognized trigger site of atrial fibrillation .Circulation 122(2):109–118. https://doi.org/10.1161/CIRCULATIONAHA.109.928903

  48. Chapeau C, Gutkowska J, Schiller PW, Milne RW, Thibault G, Garcia R, Genest J, Cantin M (1985) Localization of immunoreactive synthetic atrial natriuretic factor (ANP) in the heart of various animal species. J Histochem Cytochem 33:541–550. https://doi.org/10.1177/33.6.3158698

  49. Tabata T, Oki T, Fukuda N, Iuchi A, Manabe K, Kageji Y, Sasaki M, Yamada H, Ito S (1996) Influence of left atrial pressure on left atrial appendage flow velocity patterns in patients in sinus rhythm. J Am Soc Echocardiogr 9(6):857–864. https://doi.org/10.1016/s0894-7317(96)90478-2

  50. Vijayvergiya R, Sharma R, Shetty R, Subramaniyan A, Karna S, Chongtham D (2011) Effect of percutaneous transvenous mitral commissurotomy on left atrial appendage function: an immediate and 6-month follow-up transesophageal Doppler study. J Am Soc Echocardiogr 24(11):1260–1267. https://doi.org/10.1016/j.echo.2011.07.015

  51. Aslanabadi N, Jafaripour I, Toufan M, Sohrabi B, Separham A, Madadi R, Feazpour H, Asgharzadeh Y, Ahmadi M, Safaiyan A, Ghafari S (2015) The effects of percutaneous mitral balloon valvuloplasty on the left atrial appendage function in patients with sinus rhythm and atrial fibrillation. J Cardiovasc Thorac Res 7(1):32–37. https://doi.org/10.15171/jcvtr.2014.07

  52. Bauer F, Verdonck A, Schuster I, Tron C, Eltchaninoff H, Cribier A, Derumeaux G (2005) Left atrial appendage function analyzed by tissue Doppler imaging in mitral stenosis: effect of afterload reduction after mitral valve commissurotomy. J Am Soc Echocardiogr 18(9):934–939. https://doi.org/10.1016/j.echo.2005.05.014

  53. Chen L, Xu C, Chen W, Zhang C (2021) Left atrial appendage orifice area and morphology is closely associated with flow velocity in patients with nonvalvular atrial fibrillation. BMC Cardiovasc Disord 21(1):442. https://doi.org/10.1186/s12872-021-02242-9

  54. Di Biase L, Santangeli P, Anselmino M, Mohanty P, Salvetti I, Gili S, Horton R, Sanchez JE, Bai R, Mohanty S, Pump A, Cereceda Brantes M, Gallinghouse GJ, Burkhardt JD, Cesarani F, Scaglione M, Natale A, Gaita F (2012) Does the left atrial appendage morphology correlate with the risk of stroke in patients with atrial fibrillation? Results from a multicenter study. J Am Coll Cardiol 60(6):531–538. https://doi.org/10.1016/j.jacc.2012.04.032

  55. Nedios S, Kornej J, Koutalas E, Bertagnolli L, Kosiuk J, Rolf S, Arya A, Sommer P, Husser D, Hindricks G, Bollmann A (2014) Left atrial appendage morphology and thromboembolic risk after catheter ablation for atrial fibrillation. Heart Rhythm 11(12):2239–2246. https://doi.org/10.1016/j.hrthm.2014.08.016

  56. Ito T, Suwa M, Hirota Y, Otake Y, Moriguchi A, Kawamura K (1996) Influence of left atrial function on Doppler transmitral and pulmonary venous flow patterns in dilated and hypertrophic cardiomyopathy: evaluation of left atrial appendage function by transesophageal echocardiography. Am Heart J 131(1):122–130. https://doi.org/10.1016/s0002-8703(96)90060-5

  57. Wu MY, Lin YN, Wu HP, Huang YY, Chen JY, Lin KH, Chang KC (2019) Inverse correlation between left atrial appendage function and CHA2DS2-VASc Score in patients with atrial flutter. Sci Rep 9(1):17864. https://doi.org/10.1038/s41598-019-54505-3

  58. Akamatsu K, Ito T, Ozeki M, Miyamura M, Sohmiya K, Hoshiga M (2020) Left atrial spontaneous echo contrast occurring in patients with low CHADS2 or CHA2DS2-VASc scores. Cardiovasc Ultrasound 18(1):31. https://doi.org/10.1186/s12947-020-00213-2

  59. Puwanant S, Varr BC, Shrestha K, Hussain SK, Tang WH, Gabriel RS, Wazni OM, Bhargava M, Saliba WI, Thomas JD, Lindsay BD, Klein AL (2009) Role of the CHADS2 score in the evaluation of thromboembolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation. J Am Coll Cardiol 54(22):2032–2039. https://doi.org/10.1016/j.jacc.2009.07.037

  60. Yosefy C, Pery M, Nevzorov R, Piltz X, Osherov A, Jafari J, Beeri R, Gallego-Colon E, Daum A, Khalameizer V (2020) Difference in left atrial appendage remodeling between diabetic and nondiabetic patients with atrial fibrillation. Clin Cardiol 43(1):71–77. https://doi.org/10.1002/clc.23292

  61. Kizawa S, Ito T, Akamatsu K, Ichihara N, Nogi S, Miyamura M, Kanzaki Y, Sohmiya K, Hoshiga M (2018) Chronic kidney disease as a possible predictor of left atrial thrombogenic milieu among patients with nonvalvular atrial fibrillation. Am J Cardiol 122(12):2062–2067. https://doi.org/10.1016/j.amjcard.2018.08.058

  62. Uretsky S, Shah A, Bangalore S, Rosenberg L, Sarji R, Cantales DR, Macmillan-Marotti D, Chaudhry FA, Sherrid MV (2009) Assessment of left atrial appendage function with transthoracic tissue Doppler echocardiography. Eur J Echocardiogr 10(3):363–371. https://doi.org/10.1093/ejechocard/jen339

  63. Wai SH, Kyu K, Galupo MJ, Songco GG, Kong WKF, Lee CH, Yeo TC, Poh KK (2017) Assessment of left atrial appendage function by transthoracic pulsed Doppler echocardiography: comparing against transesophageal interrogation and predicting echocardiographic risk factors for stroke. Echocardiography 34(10):1478–1485. https://doi.org/10.1111/echo.13659

  64. Tabata T, Oki T, Yamada H, Abe M, Onose Y, Thomas JD (2000) Relationship between left atrial appendage function and plasma concentration of atrial natriuretic peptide. Eur J Echocardiogr 1(2):130–137. https://doi.org/10.1053/euje.2000.0019

  65. Hondo T, Okamoto M, Yamane T, Kawagoe T, Karakawa S, Yamagata H, Matsuura H, Kajiyama G (1995) The role of the left atrial appendage. A volume loading study in open-chest dogs. Jpn Heart J 36(2):225–234. https://doi.org/10.1536/ihj.36.225

  66. Yoshida N, Okamoto M, Hirao H, Nanba K, Kinoshita H, Matsumura H, Fukuda Y, Ueda H (2012) Role of transthoracic left atrial appendage wall motion velocity in patients with persistent atrial fibrillation and a low CHADS2 score. J Cardiol 60(4):310–315. https://doi.org/10.1016/j.jjcc.2012.05.007

  67. Doukky R, Garcia-Sayan E, Gage H, Nagarajan V, Demopoulos A, Cena M, Nazir NT, Karam GJ, Trohman RG, Kazlauskaite R (2014) The value of diastolic function parameters in the prediction of left atrial appendage thrombus in patients with nonvalvular atrial fibrillation. Cardiovasc Ultrasound 12:10. https://doi.org/10.1186/1476-7120-12-10

  68. Yoshida N, Okamoto M, Nanba K, Yoshizumi M (2010) Transthoracic tissue Doppler assessment of left atrial appendage contraction and relaxation: their changes with aging. Echocardiography 27(7):839–846. https://doi.org/10.1111/j.1540-8175.2010.01157.x

  69. Farese GE, Tayal B, Stöbe S, Laufs U, Hagendorff A (2019) Regional disparities of left atrial appendage wall contraction in patients with sinus rhythm and atrial fibrillation. J Am Soc Echocardiogr 32(6):755–762. https://doi.org/10.1016/j.echo.2019.01.016

  70. Parvathaneni L, Mahenthiran J, Jacob S, Foltz J, Gill WJ, Ghumman W, Gradus-Pizlo I, Feigenbaum H, Sawada S (2005) Comparison of tissue Doppler dynamics to Doppler flow in evaluating left atrial appendage function by transesophageal echocardiography. Am J Cardiol 95(8):1011–1014. https://doi.org/10.1016/j.amjcard.2004.12.052

  71. Holmes DR Jr, Kar S, Price MJ, Whisenant B, Sievert H, Doshi SK, Huber K, Reddy VY (2014) Prospective randomized evaluation of the Watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol 8;64(1):1–12. https://doi.org/10.1016/j.jacc.2014.04.029

  72. Osmancik P, Herman D, Neuzil P, Hala P, Taborsky M, Kala P, Poloczek M, Stasek J, Haman L, Branny M, Chovancik J, Cervinka P, Holy J, Kovarnik T, Zemanek D, Havranek S, Vancura V, Peichl P, Tousek P, Lekesova V, Jarkovsky J, Novackova M, Benesova K, Widimsky P, Reddy VY, PRAGUE-17 trial investigators (2022) 4-year outcomes after left atrial appendage closure versus nonwarfarin oral anticoagulation for atrial fibrillation. J Am Coll Cardiol 79(1):1–14. https://doi.org/10.1016/j.jacc.2021.10.023

  73. Reddy VY, Akehurst RL, Amorosi SL, Gavaghan MB, Hertz DS, Holmes DR Jr (2018) Cost-effectiveness of left atrial appendage closure with the WATCHMAN device compared with warfarin or non-vitamin K antagonist oral anticoagulants for secondary prevention in nonvalvular atrial fibrillation. Stroke 49(6):1464–1470. https://doi.org/10.1161/STROKEAHA.117.018825

  74. Sharma E, Apostolidou E, Sheikh W, Parulkar A, Ahmed MB, Lima FV, McCauley BD, Kennedy K, Chu AF (2022) Hemodynamic effects of left atrial appendage occlusion. J Interv Card Electrophysiol 64(2):349–357. https://doi.org/10.1007/s10840-021-01006-x

  75. Kim HJ, Chang DH, Kim SO, Kim JK, Kim K, Jung SH, Lee JW, Kim JB (2022) Left atrial appendage preservation versus closure during surgical ablation of atrial fibrillation. Heart 108(23):1864–1872. https://doi.org/10.1136/heartjnl-2022-320939

  76. Thomas L, Marwick TH, Popescu BA, Donal E, Badano LP (2019) Left atrial structure and function, and left ventricular diastolic dysfunction: JACC State-of-the-Art Review J Am Coll Cardiol 73(15):1961–1977. https://doi.org/10.1016/j.jacc.2019.01.059

  77. Miyazaki S, Ito T, Suwa M, Nakamura T, Kobashi A, Kitaura Y (2001) Role of transesophageal echocardiography in the prediction of thromboembolism in patients with chronic nonvalvular atrial fibrillation. Jpn Circ J 65(10):874–878. https://doi.org/10.1253/jcj.65.874

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  1. Department of Cardiology, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan

    Takahide Ito

  2. Cardiovascular Division, Hokusetsu General Hospital, Takatsuki, Japan

    Michihiro Suwa

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Takahide Ito was involved in the design and writing of the article, and Michihiro Suwa in drafting and revising for important intellectual content.

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Ito, T., Suwa, M. Assessment of left atrial appendage function by echocardiography. Heart Fail Rev 28, 1177–1187 (2023). https://doi.org/10.1007/s10741-023-10298-2

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