Evidence mapPaperPMID 40223142Full record

ArticleNeurological research and practice2025

Low blood flow velocity in the left atrial appendage in sinus rhythm as a predictor of atrial fibrillation: results of a prospective cohort study with 3 years of follow-up.

Gero Klinger, Lea Schettler, Greta Schettler, Mathias Bähr, Gerd Hasenfuß, Mark Weber-Krüger, Jan Liman, Marlena Schnieder, Marco Robin Schroeter

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Article in Neurological research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Understanding the Diseased Atria.Physiology (Bethesda, Md.) · 2026
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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Gero KlingerDepartment of Neurology, University-Medical-Center Göttingen, Göttingen, Germany. gero.klinger@med.uni-goettingen.de.ORCID http://orcid.org/0009-0007-4779-9189
Lea SchettlerHeart Center, Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.
Greta SchettlerDepartment of Neurology, University-Medical-Center Göttingen, Göttingen, Germany.
Mathias BährDepartment of Neurology, University-Medical-Center Göttingen, Göttingen, Germany.
Gerd HasenfußHeart Center, Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.
Mark Weber-KrügerHeart Center, Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.
Jan LimanDepartment of Neurology, Paracelsus Medical Private University Klinikum Nuremberg, Nuremberg, Germany.
Marlena Schnieder *Department of Neurology, University-Medical-Center Göttingen, Göttingen, Germany.
Marco Robin Schroeter *Heart Center, Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) is a common cause of cardioembolic stroke and can lead to severe and recurrent cerebrovascular events. Thus, identifying patients suffering from cardioembolic events caused by undetected AF is crucial. Previously, we found an association between increasing stroke severity and a decreasing left atrial appendage (LAA) blood flow velocity below 60 cm/s.

methodsThis was a prospective single-center cohort study including hospitalized patients who underwent a transesophageal echocardiography (TEE) in sinus rhythm. The participants were divided into two groups (≥ 60 cm/s;<60 cm/s) based on their maximum LAA blood flow velocity. The results of the cardiovascular risk assessment and 24- to 72-hour ECG Holter were recorded. Follow-up appointments were scheduled at 3, 6, 12, 24 and 36 months. The primary endpoint was new-onset AF. The statistics included a Cox-proportional-hazard-model and a binary logistic regression. Numerical data or categorical data were analyzed with the Mann-Whitney U test or chi-square test.

resultsA total of 166 patients were recruited. The median LAA blood flow velocity was 64 cm/s. New-onset AF was diagnosed in 22.9% of the patients. An LAA blood flow velocity ≤ 60 cm/s was associated with a threefold increased risk of new-onset AF (35.8% vs. 11.5%; HR3.56; CI95%1.70-7.46; p < 0.001), independently according to a multivariate analysis (p = 0.035). Furthermore, a decreasing LAA blood flow velocity was associated with an increased risk of new-onset AF (OR1.043; CI95%1.021-1.069; p < 0.001).

conclusionA low LAA blood flow velocity (≤ 60 cm/s) in sinus rhythm is prospectively associated with an increased risk of new-onset AF. Additional simple LAA-TEE examinations could help to identify patients who benefit from more accurate cardiac rhythm monitoring.

Indexed as

Atrial fibrillationIschemic strokeLeft atrial appendageTransesophageal echocardiography

Identifiers

PMID40223142
PMCPMC11995508

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.