Impact of Left Atrial Appendage Morphology and Function on Thrombosis Risk in Acute Ischemic Stroke: Insights from Transesophageal Echocardiography.

Objective: This study aims to investigate the correlation between the morphological and functional characteristics of the left atrial appendage (LAA) and the incidence of thromboembolic events by transesophageal echocardiography (TEE) in patients with acute ischemic stroke. Methods: This cross-sectional study included 171 patients with acute ischemic stroke, running from November 2022 to September 2024. Transesophageal echocardiography was performed to evaluate the presence of LAA thrombus. Multivariable logistic regression analysis was performed to identify risk factors for LAA thrombus. Results: Of the 171 patients, 19 (11.1%) were found to have LAA thrombus. Multivariable logistic regression identified two independent predictors of LAA thrombus formation: (1) left atrial spontaneous echo contrast (OR = 8, 95% CI: 3-19, p < 0.001) and (2) atrial fibrillation (OR = 8, 95% CI: 1.057-76.095, p = 0.044). Conclusions: Left atrial spontaneous echo contrast and atrial fibrillation are independent predictors of LAA thrombus in patients with acute ischemic stroke. The use of transesophageal echocardiography for early detection of LAA thrombus may help improve treatment strategies and prevent recurrent strokes.