Jung Myung Lee1,2, Jiwon Seo1, Jae-Sun Uhm1, Young Jin Kim3, Hye-Jeong Lee3, Jong-Youn Kim1, Jung-Hoon Sung4, Hui-Nam Pak1, Moon-Hyoung Lee1, Boyoung Joung1. 1. Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. 2. Division of Cardiology, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea. 3. Department of Radiology, Research Institute of Radiological Science, Yonsei University Medical College, Seoul, Korea. 4. Division of Cardiology, Department of Internal Medicine, Bundang CHA Medical Center, CHA University, Seongnam, Korea.
Abstract
BACKGROUND: A specific morphology of left atrial appendage (LAA) has been reported to be related to stroke in nonvalvular atrial fibrillation (AF) patients. However, the mechanism is not completely understood. This study evaluated whether a specific LAA morphology was related to stroke, and whether it was related to the change of flow velocity and size of LAA in AF patients. METHODS: The morphology, size, and flow velocity of LAA were evaluated in AF patients with ischemic strokes (stroke, n = 160) and age-matched AF patients without ischemic strokes (control, n = 200). RESULTS: Compared with control, the stroke group had a larger LA dimension (4.5 ± 0.7 vs. 4.2 ± 0.6 cm, P < 0.001), larger LAA orifice area (5.3 ± 2.1 vs. 4.1 ± 1.7 cm2 , P < 0.001), and slower LAA flow velocity (37 ± 19 vs. 51 ± 20 cm/s, P < 0.001). The stroke group had the chicken wing type less frequently than the control (34% vs. 50%, P = 0.003). After an adjustment for multiple potential confounding factors, the chicken wing type LAA had a decreased stroke risk (odds ratio 0.34, 95% confidence interval 0.14-0.84, P = 0.020). Patients with a chicken wing LAA had a smaller LAA orifice area (4.4 ± 1.6 vs. 4.9 ± 2.2 cm2 , P = 0.013) and higher LAA velocity (55 ± 19 vs. 41 ± 20 cm/s, P < 0.001) than those with non-chicken wing LAA. CONCLUSION: A chicken wing type of LAA was related to the less incidence of stroke. Our results suggest that the relationship between a specific LAA morphology and stroke might be partially explained by the change of the size and flow velocity of LAA.
BACKGROUND: A specific morphology of left atrial appendage (LAA) has been reported to be related to stroke in nonvalvular atrial fibrillation (AF) patients. However, the mechanism is not completely understood. This study evaluated whether a specific LAA morphology was related to stroke, and whether it was related to the change of flow velocity and size of LAA in AFpatients. METHODS: The morphology, size, and flow velocity of LAA were evaluated in AFpatients with ischemic strokes (stroke, n = 160) and age-matched AFpatients without ischemic strokes (control, n = 200). RESULTS: Compared with control, the stroke group had a larger LA dimension (4.5 ± 0.7 vs. 4.2 ± 0.6 cm, P < 0.001), larger LAA orifice area (5.3 ± 2.1 vs. 4.1 ± 1.7 cm2 , P < 0.001), and slower LAA flow velocity (37 ± 19 vs. 51 ± 20 cm/s, P < 0.001). The stroke group had the chicken wing type less frequently than the control (34% vs. 50%, P = 0.003). After an adjustment for multiple potential confounding factors, the chicken wing type LAA had a decreased stroke risk (odds ratio 0.34, 95% confidence interval 0.14-0.84, P = 0.020). Patients with a chicken wing LAA had a smaller LAA orifice area (4.4 ± 1.6 vs. 4.9 ± 2.2 cm2 , P = 0.013) and higher LAA velocity (55 ± 19 vs. 41 ± 20 cm/s, P < 0.001) than those with non-chicken wing LAA. CONCLUSION: A chicken wing type of LAA was related to the less incidence of stroke. Our results suggest that the relationship between a specific LAA morphology and stroke might be partially explained by the change of the size and flow velocity of LAA.
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
Authors: Giulio Musotto; Alessandra Monteleone; Danila Vella; Sofia Di Leonardo; Alessia Viola; Giuseppe Pitarresi; Bernardo Zuccarello; Antonio Pantano; Andrew Cook; Giorgia M Bosi; Gaetano Burriesci Journal: Front Cardiovasc Med Date: 2022-07-14