Author + information
- Nobuhiko Makino,
- Masami Nishino,
- Ayano Ishiyama,
- Akihiro Tanaka,
- Naotaka Okamoto,
- Naoki Mori,
- Yasuharu Lee,
- Takahiro Yoshimura,
- Daisuke Nakamura,
- Masayuki Taniike,
- Hiroyasu Kato,
- Yasuyuki Egami,
- Ryu Shutta,
- Hisaki Morita,
- Jun Tanouchi and
- Yoshio Yamada
Left atrial appendage (LAA) is the main source of left atrial thrombus that causes systemic embolism including stroke in patients with atrial fibrillation (AF). Many reports have revealed that LAA flow velocity (LAAV) evaluated by transesophageal echocardiography (TEE) is a promising predictor for LAA thrombus but TEE is semiinvasive. 64-multislice cardiac CT (CCT) can evaluate detailed LAA morphology. We investigated which of LAA morphologic parameters determined by CCT correlated with LAAV.
In 103 patients with AF, TEE and CCT were performed within a week. We compared the incidence of male, paroxysmal AF, hypertension, dyslipidemia, diabetes mellitus and spontaneous echo contrast evaluated by TEE and the various CCT parameters including left atrial volume, LAA volume, number of lobes, area of LAA ostium and LAA morphologic type: chicken wing type (LAA with sharp bend) and non-chicken wing type (LAA without sharp bend) between high (LAAV>30cm/sec) and low LAAV groups.
Univariate analysis showed left atrial volume, the incidence of spontaneous echo contrast, male and hypertension were significantly lower and the incidence of paroxysmal AF and chicken wing type were significantly higher in high LAAV group. Multivariate analysis revealed that chicken wing type was an independent predictor for high LAAV (table).
The morphology of LAA determined by CCT, chicken wing or non-chicken wing type, can become a new predictor of high risk patients for embolism with AF.
|Odds ratio for predicting high LAAV group||95% CI||P Value|
|Male||0.47||0.15 – 1.44||0.183|
|Paroxysmal atrial fibrillation||1.31||0.41 – 4.18||0.645|
|Hypertension||0.49||0.18 – 1.34||0.167|
|Left atrial volume (cm3)||0.99||0.98 – 1.01||0.262|
|Spontaneous echo contrast||0.44||0.11 – 1.77||0.249|
|Chicken wing type||5.22||1.64 – 16.59||0.005|
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Arrhythmias: AF/SVT II
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1107-48
- 2013 American College of Cardiology Foundation