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To the Editor,
We would like to thank Dr. Nistor (1) for his interest in our recent article entitled “Association between left atrial function assessed by speckle-tracking echocardiography and the presence of left atrial appendage thrombus in patients with atrial fibrillation.” published in Anatol J Cardiol 2017; 18: 15-22. regarding the association between left atrial function assessed by speckle-tracking echocardiography and the presence of left atrial appendage thrombus in patients with atrial fibrillation and for his insightful comments concerning our study.
Indeed, the heart rate variability poses a problem for reliable speckle-tracking echocardiography analysis during atrial fibrillation, and to handle this concern we have implemented the previously proposed method and have validated it for the assessment of left ventricular strain during atrial fibrillation (2).
With regard to the difference in left ventricular function bet-ween patients with and without left atrial appendage thrombi, we agree that it could have influenced the difference in atrial function, but at the same time, we would like to emphasize that left atrial function parameters (average left atrial longitudinal early diastolic strain rate, average left atrial longitudinal systolic strain rate, and average peak positive longitudinal systolic atrial strain) were independently associated with the presence of left atrial thrombi in the multivariate analysis.
We greatly appreciate Dr. Nistor’s comment regarding the need for further prospective clinical studies. We fully agree that additional data are essential to clarify the diagnostic role of the left atrial strain and strain rate in the choice of proper treatment for patients with atrial fibrillation.