Keiko Fukushima1, Noritoshi Fukushima2, Ken Kato3, Koichiro Ejima3, Hiroki Sato4, Kenji Fukushima5, Chihiro Saito3, Keiko Hayashi3, Kotaro Arai3, Tetsuyuki Manaka3, Kyomi Ashihara3, Morio Shoda3, Nobuhisa Hagiwara3. 1. Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan waraugocchin@hotmail.com. 2. Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan. 3. Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. 4. Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan. 5. Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Abstract
AIMS: Reduction of left atrial appendage (LAA) flow velocity (FV) is a risk factor for thrombus formation and increases the risk of stroke in patients with atrial fibrillation (AF). Furthermore, LAA morphology is correlated with stroke in patients with AF. The aim of this study was to correlate LAAFV with LAA morphology in patients with AF. METHODS AND RESULTS: We studied 96 patients (age 59.0 ± 10.2 years, 75% male) referred for radiofrequency catheter ablation for paroxysmal AF. All patients underwent computed tomography (CT) and transthoracic and transoesophageal echocardiography during sinus rhythm. LAA morphology was classified as one of the four types (chicken wing, windsock, cactus, and cauliflower) on CT images. There were significant differences in LAAFV among LAA morphologies (chicken wing 73.7 ± 21.9 cm/s, windsock 61.9 ± 19.6 cm/s, cactus 55.3 ± 14.1 cm/s, cauliflower 52.7 ± 18.1 cm/s, P = 0.008). Post hoc multiple comparisons showed that LAAFV was higher in patients with chicken wing than in those with cactus (P = 0.006, vs. chicken wing) and cauliflower (P = 0.006, vs. chicken wing), but not with windsock (P = 0.102). After adjustment for clinical and LAA anatomical covariates (orifice area, volume, and trabeculation), multiple linear regression analyses revealed that LAA morphology was an independent determinant of LAAFV [chickens wing: standardized partial regression coefficients (β) = 0.317, P = 0.0014; windsock: β = 0.303, P = 0.038]. CONCLUSION: LAA morphology is a significant determinant of LAAFV, suggesting an underlying mechanism for the association between LAA morphology and embolic events. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Reduction of left atrial appendage (LAA) flow velocity (FV) is a risk factor for thrombus formation and increases the risk of stroke in patients with atrial fibrillation (AF). Furthermore, LAA morphology is correlated with stroke in patients with AF. The aim of this study was to correlate LAAFV with LAA morphology in patients with AF. METHODS AND RESULTS: We studied 96 patients (age 59.0 ± 10.2 years, 75% male) referred for radiofrequency catheter ablation for paroxysmal AF. All patients underwent computed tomography (CT) and transthoracic and transoesophageal echocardiography during sinus rhythm. LAA morphology was classified as one of the four types (chicken wing, windsock, cactus, and cauliflower) on CT images. There were significant differences in LAAFV among LAA morphologies (chicken wing 73.7 ± 21.9 cm/s, windsock 61.9 ± 19.6 cm/s, cactus 55.3 ± 14.1 cm/s, cauliflower 52.7 ± 18.1 cm/s, P = 0.008). Post hoc multiple comparisons showed that LAAFV was higher in patients with chicken wing than in those with cactus (P = 0.006, vs. chicken wing) and cauliflower (P = 0.006, vs. chicken wing), but not with windsock (P = 0.102). After adjustment for clinical and LAA anatomical covariates (orifice area, volume, and trabeculation), multiple linear regression analyses revealed that LAA morphology was an independent determinant of LAAFV [chickens wing: standardized partial regression coefficients (β) = 0.317, P = 0.0014; windsock: β = 0.303, P = 0.038]. CONCLUSION: LAA morphology is a significant determinant of LAAFV, suggesting an underlying mechanism for the association between LAA morphology and embolic events. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Andrew Schluchter; Chelsea Jan; Katherine Lowe; Davis M Vigneault; Francisco Contijoch; Elliot R McVeigh Journal: Circ Cardiovasc Imaging Date: 2019-12-17 Impact factor: 7.792
Authors: Shadi Yaghi; Christopher Song; William A Gray; Karen L Furie; Mitchell S V Elkind; Hooman Kamel Journal: Stroke Date: 2015-10-27 Impact factor: 7.914