Decreased left atrial appendage velocity (LAAV) is considered a significant risk factor thrombus formation in the left atrial appendage (LAA). The aim of this study was to assess the role of echocardiographic left atrial (LA) function parameters in predicting LAAV in patients with persistent atrial fibrillation (AF) undergoing catheter ablation. We prospectively enrolled consecutive patients with persistent AF undergoing transesophageal echocardiography (TEE) directly before the first AF ablation in 2019–2022. Of the 150 patients enrolled in the study, 29.3% (n = 44) had reduced LAAV values defined as < 25 cm/s. Patients with decreased LAAV values exhibited significantly reduced left atrial reservoir and conduit strain (LASr and LAScd), LA emptying fraction, and average e′ values. This group also presented with a high LA stiffness index (LASI), high LA and right atrial area, and high LA volume index (LAVI) and E/e′ ratio. In multivariable logistic regression analysis, LASI and LAVI remained significant predictors of the reduced LAAV. The threshold values were 1.6 for LASI and 44.47 ml/m² for LAVI, with area under the curve values of 0.809 and 0.755, respectively. Among all noninvasive echocardiographic parameters, LASI and LAVI were found to be the best predictors of reduced LAAV, with good sensitivity and specificity. Moreover, LASI was found to be the only significant predictor of reduced LAAV defined as < 20 cm/s as well as < 25 cm/s.

左心耳流速 (LAAV) 降低被认为是左心耳 (LAA) 血栓形成的重要危险因素。本研究的目的是评估超声心动图左心房 (LA) 功能参数在预测接受导管消融的持续性心房颤动 (AF) 患者 LAAV 中的作用。我们前瞻性地招募了 2019-2022 年首次 AF 消融前连续接受经食管超声心动图 (TEE) 的持续性 AF 患者。在参与该研究的 150 名患者中，29.3% (n = 44) 的 LAAV 值降低，定义为 < 25 cm/s。 LAAV 值降低的患者表现出左心房储库和导管应变（LASr 和 LAScd）、LA 排空分数和平均 e' 值显着降低。该组还表现出高 LA 硬度指数 (LASI)、高 LA 和右心房面积、高 LA 体积指数 (LAVI) 和 E/e' 比。在多变量逻辑回归分析中，LASI 和 LAVI 仍然是 LAAV 减少的重要预测因子。 LASI 的阈值为1.6，LAVI 的阈值为44.47 ml/m ²，曲线下面积值分别为0.809 和0.755。在所有无创超声心动图参数中，LASI 和 LAVI 被发现是 LAAV 减少的最佳预测因子，具有良好的敏感性和特异性。此外，LASI 被发现是 LAAV 减少（定义为 < 20 cm/s 以及 < 25 cm/s）的唯一显着预测因子。