He Du1, Ke Bi2, Lisha Xu3, Feng Chen4, Wenfeng Xiong5, Yin Wang6. 1. Department of Internal Medicine, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China. 2. Department of Oncology, Tongji University School of Medicine, Shanghai, China. 3. Department of Ultrasound, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China. 4. Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China. 5. Shanghai Yueyang Integrated Traditional Chinese Medicine and Western Medicine Hospital, Shanghai, China. Email: xiongwf2010@163.com. 6. Department of Ultrasound, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China. Email: 916276740@qq.com.
Abstract
OBJECTIVES: Left atrial appendage (LAA) morphology is a powerful predictor of thrombogenesis of the left atrium (LA) in patients with non-valvular atrial fibrillation (NVAF). However, it remains unknown whether LAA morphology is useful for stroke risk stratification in patients with NVAF. METHODS: A total of 555 atrial fibrillation patients were divided into thrombus and non-thrombus groups according to transoesophageal echocardiography. We analysed the correlation between LAA morphology and the CHADS2 score. We determined the L2CHADS2 score and compared the ability to predict LA/LAA thrombosis of the CHADS2, L2CHADS2 and CHA2DS2-VASc scores from the area under the curve (AUC). RESULTS: The odds ratio of non-chicken wing LAA morphology was 11.48. Non-chicken wing LAA morphology was significantly correlated with LA/LAA thrombosis. We incorporated LAA morphology into the CHADS2 score and named it the L2CHADS2 score. The AUC of the L2CHADS2 score (0.767) in predicting LA/LAA thrombosis was significantly higher than that of the CHADS2 (0.558) or CHA2DS2-VASc scores (0.557). The positive and negative predictive values of the L2CHADS2 score (13.1 and 98.7%) were higher than those of the CHADS2 (8.7 and 94.2%) and CHA2DS2-VASc scores (6.9 and 6.9%). CONCLUSIONS: Non-chicken wing LAA morphology was a powerful predictor of LA/LAA thrombosis in NVAF patients. The AUC, sensitivity and specificity of the L2 CHADS2 score were higher than those of the CHADS2 and CHA2 DS2 -VASc scores.
OBJECTIVES: Left atrial appendage (LAA) morphology is a powerful predictor of thrombogenesis of the left atrium (LA) in patients with non-valvular atrial fibrillation (NVAF). However, it remains unknown whether LAA morphology is useful for stroke risk stratification in patients with NVAF. METHODS: A total of 555 atrial fibrillation patients were divided into thrombus and non-thrombus groups according to transoesophageal echocardiography. We analysed the correlation between LAA morphology and the CHADS2 score. We determined the L2CHADS2 score and compared the ability to predict LA/LAA thrombosis of the CHADS2, L2CHADS2 and CHA2DS2-VASc scores from the area under the curve (AUC). RESULTS: The odds ratio of non-chicken wing LAA morphology was 11.48. Non-chicken wing LAA morphology was significantly correlated with LA/LAA thrombosis. We incorporated LAA morphology into the CHADS2 score and named it the L2CHADS2 score. The AUC of the L2CHADS2 score (0.767) in predicting LA/LAA thrombosis was significantly higher than that of the CHADS2 (0.558) or CHA2DS2-VASc scores (0.557). The positive and negative predictive values of the L2CHADS2 score (13.1 and 98.7%) were higher than those of the CHADS2 (8.7 and 94.2%) and CHA2DS2-VASc scores (6.9 and 6.9%). CONCLUSIONS: Non-chicken wing LAA morphology was a powerful predictor of LA/LAA thrombosis in NVAF patients. The AUC, sensitivity and specificity of the L2 CHADS2 score were higher than those of the CHADS2 and CHA2 DS2 -VASc scores.
Entities:
Keywords:
atrial fibrillation; left atrial appendage morphology ; stroke; thrombus
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