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Association of Left Atrial Appendage Morphology and Function With Stroke and Transient Ischemic Attack in Atrial Fibrillation Patients.
Simon, Judit; Smit, Jeff M; El Mahdiui, Mohammed; Száraz, Lili; van Rosendael, Alexander R; Zsarnóczay, Emese; Nagy, Anikó Ilona; Gellér, Lászlo; van der Geest, Rob J; Bax, Jeroen J; Maurovich-Horvat, Pál; Merkely, Béla.
Afiliación
  • Simon J; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Budapest, Hungary.
  • Smit JM; Department of Cardiology, Leiden University Medical Center Leiden, The Netherlands.
  • El Mahdiui M; Department of Cardiology, Leiden University Medical Center Leiden, The Netherlands.
  • Száraz L; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Budapest, Hungary.
  • van Rosendael AR; Department of Cardiology, Leiden University Medical Center Leiden, The Netherlands.
  • Zsarnóczay E; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Budapest, Hungary.
  • Nagy AI; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
  • Gellér L; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
  • van der Geest RJ; Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands.
  • Bax JJ; Department of Cardiology, Leiden University Medical Center Leiden, The Netherlands; Heart Center, Turku University Hospital Turku, Finland; University of Turku, Turku, Finland.
  • Maurovich-Horvat P; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Budapest, Hungary. Electronic address: maurovich-horvat.pal@semmelweis.hu.
  • Merkely B; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Am J Cardiol ; 221: 37-43, 2024 06 15.
Article en En | MEDLINE | ID: mdl-38552710
ABSTRACT
We aimed to correlate left atrial appendage (LAA) structure and function with the history of stroke/transient ischemic attack (TIA) in patients with atrial fibrillation (AF). We analyzed the data of 649 patients with AF who were scheduled for catheter ablation. Patients underwent cardiac computed tomography and transesophageal echocardiography before ablation. The LAA morphologies depicted by cardiac computed tomography were categorized into 4 groups cauliflower, chicken wing, swan, and windsock shapes. The mean age was 61.3 ± 10.5 years, 33.9% were women. The prevalence of stroke/TIA was 7.1%. After adjustment for the main risk factors, the LAA flow velocity ≤35.3 cm/s (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.09 to 4.61, p = 0.033) and the swan LAA shape (OR 2.69, 95% CI 0.96 to 6.86, p = 0.047) independently associated with a higher risk of stroke/TIA, whereas the windsock LAA morphology proved to be protective (OR 0.32, 95% CI 0.12 to 0.77, p = 0.017) compared with the cauliflower LAA shape. Comparing the differences between the LAA morphology groups, we measured a significantly smaller LAA orifice area (389.3 ± 137.7 mm2 in windsock vs 428.3 ± 158.9 ml in cauliflower, p = 0.021) and LAA volume (7.4 ± 3.0 mm2 in windsock vs 8.5 ± 4.8 mm2 in cauliflower, p = 0.012) in patients with windsock LAA morphology, whereas the LAA flow velocity did not differ significantly. Reduced LAA function and swan LAA morphology were independently associated with a higher prevalence of stroke/TIA, whereas the windsock LAA shape proved to be protective. Comparing the differences between the various LAA morphology types, significantly lower LAA volume and LAA orifice area were measured in the windsock LAA shape than in the cauliflower LAA shape.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Ataque Isquémico Transitorio / Ecocardiografía Transesofágica / Apéndice Atrial / Accidente Cerebrovascular Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Hungria Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Ataque Isquémico Transitorio / Ecocardiografía Transesofágica / Apéndice Atrial / Accidente Cerebrovascular Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Hungria Pais de publicación: Estados Unidos